This article examines the relationship between interpersonal trust and virtual collaborative relationship (VCR) performance. Findings from a study of 10 operational telemedicine projects in health care delivery systems are presented. The results presented here confirm, extend, and apparently contradict prior studies of interpersonal trust. Four types of interpersonal trust—calculative, competence, relational, and integrated—are identified and operationalized as a single construct. We found support for an association between calculative, competence, and relational interpersonal trust and performance. Our finding of a positive association between integrated interpersonal trust and performance not only yields the strongest support for a relationship between trust and VCR performance but also contradicts prior research. Our findings indicate that the different types of trust are interrelated in that positive assessments of all three types of trust are necessary if VCRs are to have strongly positive performance. The study also established that if any one type of trust is negative, then it is very likely that VCR performance will not be positive. Our findings indicate that integrated types of interpersonal trust are interdependent, and the various patterns of interaction among them are such that they are mutually reinforcing. These interrelationships and interdependencies of the different types of interpersonal trust must be taken into account by researchers as they attempt to understand the impact of trust on virtual collaborative relationship performance.