Telehealth services that allow remote communication between the patient and the clinical team are an emerging part of care delivery. Given language barriers, patients with limited English proficiency present a unique set of challenges in integrating telehealth and ensuring equity. Using data from 84,419 respondents in the 2015-18 California Health Interview Survey, we assessed the association between limited English proficiency and telehealth use (telephone and video visits) and evaluated the impact of telehealth use on health care access and use. We found that patients with limited English proficiency had lower rates of telehealth use (4.8 percent versus 12.3 percent) compared with proficient English speakers. In weighted multivariable logistic regression, patients with limited English proficiency still had about half the odds of using telehealth. Telehealth use was associated with increased emergency department use for all patients. This study suggests that policy makers and clinicians must focus on limited English proficiency as an important dimension to promote telehealth equity and decrease digital divides. F or the 25.6 million people with limited English proficiency in the US, language barriers pose a significant challenge to their health care experience and receipt of high-quality care. 1 Patients with limited English proficiency experience significant disparities in care including increased numbers of hospitalizations, lengths-ofstay, numbers of thirty-day readmissions, and numbers of emergency department (ED) visits and decreased access to preventive services. [2][3][4][5] The equitable deployment of technology offers opportunities to ameliorate these gaps. 6 Telehealth represents an emerging technology that could bridge gaps in care. Evidence suggests that extending care beyond the clinic setting improves access. 7,8 Telehealth has been shown to improve patient satisfaction, care access, and outcomes in multiple diseases, including dermatologic conditions, diabetes, cerebrovascular disease, and alcohol use disorder. 7,9-13 National-