Twilio provides a simple way to send and receive text messages in Ruby, allowing developers to build various applications such as appointment reminders, marketing notifications, and mobile marketing campaigns. The Twilio-Ruby library can be used to create an SMS gateway using Sinatra, a lightweight web framework. By following the provided code example, developers can quickly get started with sending and receiving SMS messages in their Ruby projects. With this foundation, they can build more complex applications, such as automated SMS workflows or customer engagement systems.