The Individuals with Disabilities Education Act (IDEA, 2004) governs the Early Intervention (EI) system for families of children aged zero to three with developmental delays and disabilities. As a result of the COVID-19 pandemic, many states offer telehealth as a way for families to receive their EI services. Given the limited EI providers in rural areas, it seems that telehealth may especially help rural families to access EI services. However, little research has been done in relation to family use and satisfaction with telehealth in relation to rurality. To this end, we conducted a statewide survey of 256 families of children in EI about their use of EI services via telehealth. There was a negative correlation between family satisfaction with telehealth and rurality, with rural families being more dissatisfied with telehealth. Implications for practice and research are discussed.