Objective: To discuss the application process and model innovation of 5G remote robotic ultrasound examination in network remote consultation and free consultation in border and pastoral areas in Kezhou, Xinjiang, and summarize the application experience of 356 cases. Methods: A total of 356 cases of 5G remote ultrasound examination carried out in our model interactive internet hospital and 156 cases of outpatient bedside ultrasound examination in our hospital from June 2020 to April 2022 were retrospectively analyzed. Statistics on examination items, signal transmission parameters, application experiences of both doctors and patients, and diagnostic efficiency were conducted. Results: Among 356 cases, there were 114 cases of ultra-remote network consultation from Nanjing, Jiangsu to Kezhou, Xinjiang, 185 cases of remote network consultation in the Kezhou area, and 57 cases of remote free consultation in the Kezhou area. No significant difference in the composition of examination items was observed in comparison with 156 cases of bedside ultrasound. Compared with ultra-remote consultation from Nanjing to Kezhou and remote free consultation, higher signal transmission bandwidth (<0.001), shorter delay (<0.001), and lower packet loss rate (<0.001) were noticed in remote consultation in Kezhou area. For doctors, the operation satisfaction (P<0.05), image satisfaction (P<0.05), and communication satisfaction (P<0.05) of ultra-remote ultrasound from Nanjing to Kezhou and remote free consultation were significantly lower than those of traditional bedside ultrasound, while no obvious difference existed between remote ultrasound in Kezhou area and bedside ultrasound (P>0.05). For patients, there was no significant difference in acceptance between ultra-remote consultation from Nanjing to Kezhou and traditional bedside ultrasound (P>0.05). Compared with traditional ultrasound, patients were more nervous during remote robotic ultrasound examination (P<0.05), but the latter had more advantages in probe compression comfort (P<0.05) and privacy protection satisfaction (P<0.001). No significant difference on disease detection rate and diagnostic efficiency was observed between ultra-remote consultation from Nanjing to Kezhou and traditional ultrasound. Conclusions: The clinical application system of 5G remote robotic ultrasound examination has been preliminarily established. Although there are still shortcomings in communication technology and clinical application, it is conducive to promoting the effective sinking of high-quality medical resources from developed areas in the eastern coastal areas to the border areas of the motherland, which is a valuable practice and model innovation in medical system reform of the National Health Commission.