diff --git a/apps/Backend/src/ai/confirmationSms.ts b/apps/Backend/src/ai/confirmationSms.ts
new file mode 100644
index 00000000..c850f7cc
--- /dev/null
+++ b/apps/Backend/src/ai/confirmationSms.ts
@@ -0,0 +1,48 @@
+import twilio from "twilio";
+import { prisma as db } from "@repo/db/client";
+import { storage } from "../storage";
+
+const CONFIRMATION_FALLBACKS: Record<string, (dateLabel: string, time: string) => string> = {
+  English:          (d, t) => `Confirmed! Your appointment is on ${d} at ${t}. We look forward to seeing you.`,
+  Spanish:          (d, t) => `¡Confirmado! Su cita es el ${d} a las ${t}. Le esperamos.`,
+  Portuguese:       (d, t) => `Confirmado! Sua consulta é em ${d} às ${t}. Aguardamos sua visita.`,
+  Mandarin:         (d, t) => `已确认！您的预约在 ${d} ${t}。期待您的光临。`,
+  Cantonese:        (d, t) => `已確認！您的預約喺 ${d} ${t}。期待見到您。`,
+  Arabic:           (d, t) => `تم التأكيد! موعدك في ${d} الساعة ${t}. نتطلع لرؤيتك.`,
+  "Haitian Creole": (d, t) => `Konfime! Randevou ou se ${d} a ${t}. N'ap tann ou.`,
+};
+
+/**
+ * Sends a standalone appointment-confirmation text, independent of whichever
+ * channel (SMS chat or AI phone call) the booking conversation happened on —
+ * a voice-booked appointment would otherwise leave the patient with nothing
+ * to refer back to once the call ends. Swallows all errors so a notification
+ * failure never breaks the booking flow that already succeeded.
+ */
+export async function sendAppointmentConfirmationSms(
+  userId: number,
+  patientId: number,
+  dateLabel: string,
+  time: string,
+  lang: string,
+): Promise<void> {
+  try {
+    const [twilioSettings, patient] = await Promise.all([
+      storage.getTwilioSettings(userId),
+      db.patient.findUnique({ where: { id: patientId }, select: { phone: true } }),
+    ]);
+    if (!twilioSettings || !patient?.phone) return;
+
+    const build = CONFIRMATION_FALLBACKS[lang] ?? CONFIRMATION_FALLBACKS["English"]!;
+    const body  = build(dateLabel, time);
+
+    const client = twilio(twilioSettings.accountSid, twilioSettings.authToken);
+    await client.messages.create({ body, from: twilioSettings.phoneNumber, to: patient.phone });
+
+    await storage.createCommunication({
+      patientId, userId, channel: "sms", direction: "outbound", status: "sent", body,
+    });
+  } catch {
+    // Silent — don't crash the booking flow over a notification failure
+  }
+}
diff --git a/apps/Backend/src/ai/patient-conversation-router.ts b/apps/Backend/src/ai/patient-conversation-router.ts
index d0055619..67cf7657 100644
--- a/apps/Backend/src/ai/patient-conversation-router.ts
+++ b/apps/Backend/src/ai/patient-conversation-router.ts
@@ -15,6 +15,7 @@ import {
 } from "./reschedule-graph";
 import { getLlm, type AiProvider } from "./llm-factory";
 import { runEligibilityProcessor } from "../queue/processors/eligibilityProcessor";
+import { sendAppointmentConfirmationSms } from "./confirmationSms";
 import {
   getPendingReschedule, setPendingReschedule, clearPendingReschedule,
   setStage, type ConversationStage,
@@ -604,6 +605,7 @@ export async function routePatientTurn(params: {
           status:     "scheduled",
           movedByAi:  true,
         } as any);
+        await sendAppointmentConfirmationSms(patient.userId, patient.id, pending.dayLabel, timeLabel(startTime), language);
       } catch { /* silent — message still sent, staff can create manually */ }
     }
 
diff --git a/apps/Backend/src/ai/recall-graph.ts b/apps/Backend/src/ai/recall-graph.ts
index 9d204670..1b6b4ce3 100644
--- a/apps/Backend/src/ai/recall-graph.ts
+++ b/apps/Backend/src/ai/recall-graph.ts
@@ -10,6 +10,7 @@ import {
   parseDateOnlyFromMessage, parseTime, isOfficeDayOpen, isWithinOfficeHours,
   getOfficeHoursDisplay, timeLabel,
 } from "./reschedule-graph";
+import { sendAppointmentConfirmationSms } from "./confirmationSms";
 
 const GraphState = Annotation.Root({
   message:          Annotation<string>(),
@@ -400,6 +401,7 @@ async function bookRecallSlot(
   const build = slot.matchedRequest
     ? (BOOKED_EXACT_FALLBACKS[lang] ?? BOOKED_EXACT_FALLBACKS["English"]!)
     : (BOOKED_ALT_FALLBACKS[lang]   ?? BOOKED_ALT_FALLBACKS["English"]!);
+  await sendAppointmentConfirmationSms(userId, patientId, dateLabel, timeLbl, lang);
   return { reply: build(dateLabel, timeLbl), nextStage: "done" };
 }
 
diff --git a/apps/Backend/src/ai/reschedule-graph.ts b/apps/Backend/src/ai/reschedule-graph.ts
index 1e492c33..8cd8612c 100644
--- a/apps/Backend/src/ai/reschedule-graph.ts
+++ b/apps/Backend/src/ai/reschedule-graph.ts
@@ -7,6 +7,7 @@ import {
   getPendingReschedule,
   clearPendingReschedule,
 } from "./aiHandoffStore";
+import { sendAppointmentConfirmationSms } from "./confirmationSms";
 
 // ── Date helpers ──────────────────────────────────────────────────────────────
 
@@ -837,6 +838,8 @@ export async function runRescheduleStep(
       fallback,
       apiKey, provider, model
     );
+    const datePart = displayLabel.split(" at ")[0] ?? displayLabel;
+    await sendAppointmentConfirmationSms(userId, patientId, datePart, timeLabel(startTime), lang);
     return { reply, nextStage: "done" };
   }
 
@@ -1126,6 +1129,7 @@ export async function runRescheduleStep(
       `You are a friendly dental office assistant. The patient's appointment has been rescheduled to ${apptLabel}. Confirm in ${lang}: say the appointment is moved to ${apptLabel} and that our dental receptionist will confirm it with them tomorrow. 2 sentences, no formatting.`,
       `Appointment moved to ${apptLabel}.`, fallback, apiKey, provider, model
     );
+    await sendAppointmentConfirmationSms(userId, patientId, pending.dayLabel, timeLabel(startTime), lang);
     return { reply, nextStage: "done" };
   }