Abstract Despite its prevalence, quality treatment for trichotillomania is often difficult to find. The use of telepsychology has been an effective method for disseminating treatment services for a variety of mental health conditions. However, no research has examined the use of telepsychology to treat trichotillomania. This randomized controlled trial used Acceptance and Commitment Therapy Enhanced Behavior Therapy delivered by way of telepsychology to treat trichotillomania in adults. The study compared an active treatment condition (n = 12) to a delayed treatment waitlist control condition (n = 10). Results showed significant reductions in hair pulling severity from pre- to post-treatment compared to the waitlist condition. The 22 participants all received treatment and were combined to examine overall treatment effects from pre-treatment to a 12-week follow-up. The effect of treatment on hair pulling severity remained significant at follow-up. Measures of psychological flexibility and perceived shame also saw significant improvement. Quality of life, however, did not improve over the course of treatment. The findings demonstrate that telepsychology is a viable option to disseminate treatment for trichotillomania.