There are many opportunities to leverage telehealth and telemedicine to increase access to preventive and specialty care, address health disparities affecting vulnerable populations, and save costs. For rural and underserved areas, telehealth can reduce transportation barriers and address workforce shortages. This guide for state and territorial health officials include background information on telehealth and its different modalities, an overview of telehealth legislation and regulation at the federal and state levels, and considerations for developing a telehealth pilot.