Objective: E-health may enable the empowerment process for patients, particularly the chronically ill. However, e-health is not always designed with the requirements of patient empowerment in mind. Drawing on evidence-based e-health studies, we propose directions for best practices to develop e-health that promotes patient empowerment. Methods: The concept of patient empowerment in the Dutch setting is discussed first. The prerequisites for patient empowerment are then described and translated into empowerment areas relevant to e-health. Materials: We reviewed Dutch e-health studies that provide insights into what works, and what does not, in e-health. Results: On the basis of the lessons learned from the studies, we propose directions for best practices to develop e-health that promotes patient empowerment. These directions cover various aspects, such as the design and implementation of e-health, its information content and usability, awareness, and acceptance. The studies also indicate the difficulty of establishing that e-health is really dedicated to patient empowerment. Conclusions: Despite the body of knowledge about patient empowerment, as well as the technological visibility of e-health, evidence for best practices in general and for patient empowerment in particular is scarce. We call for a more systematic evaluation of e-health for patient empowerment and more reliable evidence. Beyond the organizational and technical issues involved in e-health, there is also a need to demonstrate its practical benefits to patients. The Netherlands is active in developing sustainable e-health. National initiatives are now in place to support the processes with the aim of establishing the required evidence-based best practices. © 2010, Mary Ann Liebert, Inc.