The WVCTSI Project ECHO program, supported by funding and collaboration from the West Virginia Clinical & Translational Science Institute (WVCTSI), the Claude Worthington Benedum Foundation, the WVU School of Medicine, Cabin Creek Health Systems, and The WV Primary Care Association, was developed in 2016. This program offers primary care providers and teams an exceptional opportunity to enhance their knowledge and skills in various specialty areas, completely free of charge. The training sessions are conveniently conducted through video conferencing technology, enabling delivery directly to their clinics. Since its launch in 2016, the ECHO program has significantly expanded and now covers 10 different clinical areas, including HCV/HIV and Substance Use Disorder (SUD). The WVCTSI Project ECHO has successfully trained and mentored over 1,500 individual providers who serve rural populations not only in West Virginia but also in 20 other states with substantial rural communities.