In this chapter, we study interaction in systemic online supervision in Finland. The study data comprise video recordings of 24 authentic supervision sessions and their written transcripts, questionnaires on job strain and the working alliance in the sessions, and participants’ physiological activation (HRV) measured with a finger pulse oximeter. We discuss observations that we made on how communication technology can affect interaction in remote systemic supervision: (1) distractions related to the online environment, (2) lack of transition from daily tasks to supervision sessions, (3) challenges in promoting and maintaining a common “choreography” in sessions, and (4) the different organization of speech turns compared to face-to-face meetings. To gain understanding of the features of interaction that may promote shared reflection and help to overcome the challenges related to online environments, we analyze an episode rated by the participants as particularly useful. In addition to verbal communication, we pay close attention to participants’ nonverbal behaviors and physiological activation (HRV) in the session. We conclude with making suggestions for improving practice in online systemic supervision.