The use of SMS messaging in medical practices can provide benefits such as minimizing no-show appointments, improving interactions between providers and patients, and providing more effective care instructions while saving resources. However, sending SMS messages requires HIPAA compliance due to the potential exposure of protected health information (PHI). Healthcare providers must acquire opt-ins from patients and implement safeguards such as two-factor authentication to protect PHI. Choosing a HIPAA-eligible SMS provider is crucial in ensuring legal obligations are met. Providers can use SMS to provide emergency communications, remind patients to take their medicine, and offer more complete ongoing care with patients. By following best practices and using a HIPAA-compliant SMS provider, medical practices can effectively utilize text messaging while maintaining patient trust and security.