Data from 532 Pakistani telehealth users demonstrates dramatic cost reduction from PKR 4,800 for in-person visits to PKR 2,000 for virtual consultations, with acceptance rates strongly correlated to comfort levels (odds ratio 4.15-20.3) and perceived care quality (OR 2.59). This Pakistani telehealth evaluation adds crucial developing-world evidence to a field dominated by Western studies, showing that cost barriers—not just geographic access—may be telehealth's most significant advantage. The 58% cost reduction likely reflects eliminated transportation, accommodation, and lost income expenses that disproportionately burden lower-income populations. While connectivity and privacy concerns persist, the acceptance predictors mirror patterns seen in affluent healthcare systems, suggesting universal psychological factors drive telehealth adoption. For global health equity, these findings indicate telehealth could democratize specialist access in resource-constrained settings where travel costs often exceed consultation fees. However, the study's cross-sectional design captures only patients who completed telehealth visits, potentially missing those deterred by technology barriers. The dominance of younger, urban participants also questions rural scalability—precisely where telehealth promises greatest impact.