Telehealth has the potential to extend access to lifesaving treatment for opioid use disorder (OUD) among underserved people living with HIV (PWH). However, policymakers have scaled back pandemic-era telehealth provisions, citing concerns about safety and effectiveness. In this study of 42 PWH with OUD in one Deep South HIV clinic between 3/1/2020 and 4/30/2021, we used multivariable regression to assess the impact of telehealth utilization on patient-centered HIV and OUD outcomes. We found no significant difference in outcomes for those with high telehealth utilization versus others. In addition to being more accessible, telehealth does not appear to compromise health outcomes.