Introduction: Access to otolaryngology services in rural and remote Australia is limited by geography, workforce shortages, and prolonged waiting times for specialist review. Otoscopy is fundamental to the assessment of ear disease but is often limited by variable skill levels and limited access to specialist equipment in remote settings. Smartphone-assisted otoscopy has emerged as a potential tool to support remote assessment and telehealth models of care. Aim: To review the current evidence for smartphone-assisted otoscopy in remote ENT assessment and discuss its potential role in improving access to ENT surgical services in rural Australia. Methods: A narrative review of the literature was performed, focusing on studies evaluating smartphone-compatible otoscopes used in community, primary care, and remote settings. Outcomes of interest included diagnostic accuracy, feasibility for remote assessment, impact on referral pathways, and integration with telehealth services. Results: Smartphone-assisted otoscopy enables acquisition and transfer of high-quality otoscopy images from non-specialist settings, facilitating remote specialist review. Studies demonstrate improved diagnostic confidence and referral quality for common otological conditions, including otitis media and tympanic membrane pathology. These systems have been successfully integrated into telehealth pathways, supporting earlier identification of patients requiring surgical assessment. Discussion: Deployment of smartphone-assisted otoscopes in rural Australia may improve ENT service delivery by enabling remote assessment, optimising referral prioritisation, and reducing unnecessary patient travel. Challenges include device cost, training requirements, image quality variability, data governance, and medicolegal considerations. Conclusion: Smartphone-assisted otoscopy represents a practical adjunct for improving access to ENT assessment and surgical care in rural and remote Australia. Further evaluation of implementation models within the Australian healthcare system is warranted.