To send and respond to text messages with Perfect and Twilio, developers can follow a step-by-step process. First, they need to set up their environment by installing Perfect using the Swift Package Manager, setting up a Twilio phone number, and configuring ngrok. Then, they create a route in `main.swift` to handle incoming SMS messages, which are then responded to with the same message sent. Finally, they launch an HTTP server and run the application, allowing them to send and receive text messages using their Twilio phone number. This process can be used in various environments such as Heroku, Amazon Web Services, Docker, Microsoft Azure, Google Cloud, and IBM Bluemix CloudFoundry.