To our knowledge there have been no previous studies that have examined the effect of short messaging service (SMS) text messaging reminders to both mobile and landlines on the 'did not attend' (DNA) rate in adult hospital clinic attendees. Our aim was to determine the effectiveness of a text messaging reminder in improving attendance in return general ophthalmology clinic patients. Ophthalmology clinic patients requiring a follow-up appointment were invited to enter the study. An information leaflet was provided and patients were contacted two weeks before their scheduled appointment by way of a customized text message to either the mobile phone or landline. The non-attendance rate compared with historic non-attendance rate was recorded. Two hundred and one patients were recruited. The historic DNA rate was 12%. The DNA rate in the SMS text reminder group was reduced to 5.5% (11 patients). The historic 'Could not attend' (CNA) rate of 6% had been reduced to 2% (4 patients). Forty-seven percent of patients used mobile phone technology with text messaging capability and 69% responded to the text reminder. In conclusion, routine SMS texting is a cost-effective means of reducing DNAs and should become standard practice. In addition, two-way messaging could allow for further efficiency as advance notification of patient cancellations facilitates re-scheduling of alternative patients.