Twin Hills fishermen generally sell their fish to the Togiak Fisheries cannery located on Togiak Bay near the mouth of the Twin Hills River. In addition, several cash buyers normally provide markets in Togiak Bay. Some residents also fish in the Togiak sac roe fishery, mainly as gillnetters. Winter employment opportunities are very limited and residents rely heavily on subsistence activities. The State of Alaska maintains a 3,000 foot gravel runway.
Air transportation is the primary method of passenger travel to and from the village.
Peninsula Airways, Tucker Air, Yute Air, Grant Aviation, Arctic Circle Air, Bristol Bay Air, Bay Air, and A-Ball Air provide air taxi service to the village. Large air freight such as trucks is normally picked up in Togiak. Barge freight destined for the village from Seattle and Anchorage is first sent to Dillingham. The goods are then transported to Twin Hills by lighterage companies using smaller barges and landing crafts that pull up to the beach. There are about three miles of gravel roads within the village and a five-mile gravel road from the village to the beach.