Seal oil is exchanged blackfish. Handicraft also supplement incomes. Twin Hills is primarily accessible by air and water. Regular and charter flights are available from Dillingham. There is a State-owned 3,000' lighted gravel runway.
Most cargo is delivered by air.
There are no docking facilities, so bulk goods must be lightered to shore. Autos, ATVs and snowmachines are used for local transportation. Residents drive along the beach to access the Togiak Fisheries cannery.