Aims and objectives The aim of this study was to explore caller satisfaction with interaction, and the association to overall satisfaction with calls. Background In the era of expanding healthcare at distance, the telephone remains a common tool for the provision of nursing care. Interaction between telenurse and caller in telenursing is vital for safety, satisfaction and adherence reasons. Few studies have quantitatively explored interaction in calls and how it relates to overall satisfaction with calls. Design Cross-sectional survey study with a deductive approach. Methods A total of 466 callers to the Swedish Medical Advisory Service completed the Telenursing Interaction and Satisfaction Questionnaire. Satisfaction with four theoretically defined components of interaction were compared using repeated measures ANOVA. Associations between satisfaction with interaction and overall satisfaction with calls were evaluated with ordinal logistic regression models with and without adjustment for age, sex, health status, waiting time, time for call, main result of the call and expectations. The study followed the STROBE checklist. Results Callers were most satisfied with affective support, followed by professional-technical competence, health information and decisional control-in that order. A summated score of satisfaction with interaction was positively and significantly associated with overall satisfaction with calls before and after adjustment for waiting time, main result of call and variables related to the individual caller. Conclusions Caller satisfaction with interaction is generally high but can be improved, especially regarding decisional control. Satisfaction with interaction is important for overall satisfaction with calls. Relevance to clinical practice This study provides support for professionals at all levels in telenursing organisations to pay attention to interactional matters. The development of best practice for telenurses needs to consider all four components of interaction to enhance satisfaction with calls.