The COVID-19 pandemic caused profound disruptions to healthcare delivery worldwide, necessitating rapid innovation to ensure continuity of care while minimizing infection risk. Nurse-led telehealth interventions emerged as a vital strategy during this period, enabling nurses to deliver safe, effective, and patient-centered care through digital platforms. This article reviews nurse-led telehealth interventions implemented during the COVID-19 pandemic, drawing on evidence from the last ten years to examine their scope, effectiveness, and challenges. Nurses utilized a range of telehealth modalities, including video consultations, telephone follow-ups, asynchronous messaging, and remote patient monitoring, to support COVID-19 symptom surveillance, chronic disease management, mental health care, health education, and care coordination. Findings indicate that nurse-led telehealth significantly improved access to healthcare services, reduced unnecessary hospital visits, maintained continuity of care during lockdowns, and enhanced patient satisfaction. Remote monitoring and virtual triage facilitated early identification of clinical deterioration, particularly among patients with mild to moderate COVID-19 managed at home. In addition, nurse-led telehealth played a critical role in addressing psychosocial distress and supporting self-management among individuals with chronic conditions. Despite these positive outcomes, several challenges were identified, including digital inequities, limited technological infrastructure, regulatory and reimbursement barriers, increased nursing workload, and the need for rapid development of digital competencies. Ethical and legal considerations related to privacy, data security, and equitable access further influenced telehealth implementation. Overall, the evidence highlights nurse-led telehealth as a safe, effective, and adaptable model of care that strengthened healthcare system resilience during the pandemic. Sustained policy support, investment in nursing education, and digital infrastructure are essential to integrate nurse-led telehealth into routine practice and prepare health systems for future public health emergencies.