This study investigated the possibilities and obstacles for cross-border electronic prescriptions within the European internal market. Cross-border electronic prescribing requires interoperability of the systems and use of standardized solutions. We conducted a survey-based case study. A questionnaire on the use of electronic prescriptions was sent by e-mail to the delegates from 14 European Union (EU) member countries and 2 European Economic Area (EEA) countries during spring-summer 2003. A reply was received from 11 delegates in 11 countries contacted. Currently electronic prescriptions are in everyday use in only a few EU member countries, while many others are running or considering pilot projects. We found that electronic prescribing across national borders is impeded by many obstacles, which may relate to other systems or to lack of standardization. Information technology is likely to gradually spread to prescribing in Europe. Before more countries will integrate electronic prescribing into national healthcare, it would be important to ensure interoperability and common standards between national systems. Only then can electronic prescribing offer its full potential, and cross-border electronic prescribing can be realized at the EU level.