Purpose The purpose of this study was to determine (a) whether the use of short message service (SMS) appointment reminders is an acceptable form of communication about colonoscopy appointments and (b) whether the use of SMS appointment reminders is as efficacious as the use of telephone reminders calls for colonoscopy completion. Methods Patients referred by a primary care physician for a screening colonoscopy (N=24) were recruited to participate over a 10-month period. Eligible participants (i.e., owned a cell phone and agreed to receive text reminders) were randomized to receive either usual care (N=13) or SMS reminders (N=11). Participants were given 3 months to complete the exam followed by analysis of colonoscopy completion status. Results In the non-SMS group, 46.2 % participants completed a colonoscopy compared to 72.7 % of participants in the SMS group (p=0.19). Conclusions SMS has potential to be an efficacious approach for use within patient navigation interventions for screening colonoscopy and that using SMS reminders for colonoscopy patient navigation interventions should be replicated in a randomized clinical trial, with a larger sample size.