Treatment initiation and engagement of clients with posttraumatic stress disorder (PTSD) can be challenging due to early treatment dropout when a client with PTSD is unwilling to confront feared trauma-related stimuli and experience anxious arousal during exposure. Increased attention to these engagement issues is especially warranted with traditionally underserved populations (i.e., ethnic minorities, low socioeconomic status, rural residence). This case study describes Victor, a 34-year-old Latino man victimized during a robbery in the rural Southeastern United States, and explains the successful cultural modifications made to Victor’s 10 sessions of prolonged exposure (PE) therapy. Telemedicine, or conducting therapy sessions over a secure Internet connection, was used to overcome barriers associated with rural clients with limited access to specialized and bilingual services. Victor showed marked reductions in PTSD symptoms after completion of PE via telemedicine. This article explains the client’s presenting complaints, history, assessment, barriers to care, cultural modifications, and treatment implications.