BACKGROUND: Mobile phone SMS is increasingly used as a means of communication between patients and their healthcare providers in many countries of the world. We investigated mobile phone use and factors associated with willingness-to-pay (WTP) for diabetes SMS among patients with type 2 diabetes in Bangladesh. METHODS: As part of a randomized controlled study, in 515 patients with type 2 diabetes, socioeconomic status, mobile phone use, WTP for diabetes SMS, anthropometry and HbA1c were measured. Multivariate regression was used to identify factors associated with WTP. RESULTS: The median (interquartile range [IQR]) of WTP for diabetes SMS was 20 (45) Bangladesh Taka (BDT) (1 BDT = 0.013 US$). WTP was significantly higher for males [OR 2.4, 95% CI (1.0-5.7)], patients with household income >50 000 BDT [4.6 (1.1-20.4)] and those with primary education [5.6 (1.2-26.6)] and secondary and higher education [5.2 (1.4-19.6)]. CONCLUSIONS: The high proportion of mobile phone use and WTP for diabetes SMS are encouraging as possible strategy to use such technologies and deserve further evaluation.