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Another drawback of VoIP service is its reliance upon another separate service - an Internet connection. The quality and overall reliability of the phone connection is entirely reliant upon the quality, reliability, and speed of the Internet connection which it is using. Shortcomings with Internet connections and Internet Service Providers (ISPs) can affect VoIP calls. Higher overall network latencies can lead to significantly reduced call quality and cause certain problems such as echoing. Certain providers, such as Time Warner Cable, offer a Voice over IP product to their customers without requiring an Internet service.

VoIP is not entirely reliant upon internet connections, however. VoIP systems can also utilize regular telephone lines and business-grade connections like T1 for voice service. A few business VoIP providers offer dedicated point-to-point T1 connections, not relying on an Internet connection for service. Although residential VoIP service typically uses only an Internet connection, business-grade VoIP service can use a variety of connection methods to provide ongoing phone service.

Many VoIP users still maintain a traditional analog voice line (business line) which allows them to dial emergency numbers and utilize a traditional fax machine.

Another drawback of VoIP is the likely inability to make phone calls during a power outage, though this problem is shared with some conventional phones which require more power than the landline itself can supply. Cordless phone units in particular are more affected by power outages as many do not have a battery backup option for the base station. This can be remedied with a battery backup like an Uninterruptible Power Supply. During a power outage one also has the choice to forward calls to a cell phone or alternate number.

If VoIP is used in solitary LAN (with no Internet connection), it would consume more resources compared to a PABX.

Modems are now available with lithium ion battery backup so the service can be used with no external power.

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