diff --git a/run/service-health/go.mod b/run/service-health/go.mod
index dc45bad154..5b0775ae35 100644
--- a/run/service-health/go.mod
+++ b/run/service-health/go.mod
@@ -5,6 +5,7 @@ go 1.23.0
 require (
 	cloud.google.com/go/storage v1.55.0
 	google.golang.org/api v0.235.0
+	google.golang.org/grpc v1.72.1
 )
 
 require (
@@ -52,6 +53,5 @@ require (
 	google.golang.org/genproto v0.0.0-20250505200425-f936aa4a68b2 // indirect
 	google.golang.org/genproto/googleapis/api v0.0.0-20250512202823-5a2f75b736a9 // indirect
 	google.golang.org/genproto/googleapis/rpc v0.0.0-20250512202823-5a2f75b736a9 // indirect
-	google.golang.org/grpc v1.72.1 // indirect
 	google.golang.org/protobuf v1.36.6 // indirect
 )
diff --git a/run/service-health/layout.html b/run/service-health/layout.html
index b0b02e72c3..bfc4c860a5 100644
--- a/run/service-health/layout.html
+++ b/run/service-health/layout.html
@@ -69,8 +69,18 @@ <h2>Readiness probe is {{.HealthStr}} on this instance!</h2>
       period seconds: <code>{{.ReadinessProbeConfig.PeriodSeconds}}</code>,
       success threshold: <code>{{.ReadinessProbeConfig.SuccessThreshold}}</code>,
       failure threshold: <code>{{.ReadinessProbeConfig.FailureThreshold}}</code>,
-      http path: <code>{{.ReadinessProbeConfig.HttpGetAction.Path}}</code>,
-      http port: <code>{{.ReadinessProbeConfig.HttpGetAction.Port}}</code>.
+      {{if .ReadinessProbeConfig.HttpGetAction.Path}}
+        http path: <code>{{.ReadinessProbeConfig.HttpGetAction.Path}}</code>,
+      {{end}}
+      {{if .ReadinessProbeConfig.HttpGetAction.Port}}
+        http port: <code>{{.ReadinessProbeConfig.HttpGetAction.Port}}</code>.
+      {{end}}
+      {{if .ReadinessProbeConfig.GrpcAction.Service}}
+        grpc path: <code>{{.ReadinessProbeConfig.GrpcAction.Service}}</code>,
+      {{end}}
+      {{if .ReadinessProbeConfig.GrpcAction.Port}}
+        grpc port: <code>{{.ReadinessProbeConfig.GrpcAction.Port}}</code>.
+      {{end}}
     </p>
     {{end}}
 
@@ -217,4 +227,4 @@ <h3>Serving instances for this service:</h3>
   </script>
 </body>
 
-</html>
\ No newline at end of file
+</html>
diff --git a/run/service-health/main.go b/run/service-health/main.go
index 3dae8cdcdd..80d4c7cd2e 100644
--- a/run/service-health/main.go
+++ b/run/service-health/main.go
@@ -21,6 +21,7 @@ import (
 	"html/template"
 	"io"
 	"log"
+	"net"
 	"net/http"
 	"os"
 	"slices"
@@ -29,6 +30,9 @@ import (
 
 	"cloud.google.com/go/storage"
 	"google.golang.org/api/iterator"
+	"google.golang.org/grpc"
+	"google.golang.org/grpc/codes"
+	healthpb "google.golang.org/grpc/health/grpc_health_v1"
 )
 
 var (
@@ -78,9 +82,13 @@ type ReadinessProbeConfig struct {
 	SuccessThreshold int `json:"successThreshold"`
 	FailureThreshold int `json:"failureThreshold"`
 	HttpGetAction    struct {
-		Path string `json:"path"`
-		Port int    `json:"port"`
+		Path *string `json:"path"`
+		Port *int    `json:"port"`
 	} `json:"httpGet"`
+	GrpcAction struct {
+		Service *string `json:"service"`
+		Port    *int    `json:"port"`
+	} `json:"grpc"`
 }
 
 type Service struct {
@@ -97,6 +105,10 @@ type Service struct {
 	} `json:"spec"`
 }
 
+type healthServer struct {
+	healthpb.UnimplementedHealthServer
+}
+
 func init() {
 	var err error
 
@@ -205,6 +217,8 @@ func main() {
 		}
 	}()
 
+	go startGrpcServer(8081)
+
 	port := os.Getenv("PORT")
 	if port == "" {
 		port = "8080"
@@ -222,6 +236,33 @@ func main() {
 	}
 }
 
+func startGrpcServer(port int) {
+	lis, err := net.Listen("tcp", fmt.Sprintf(":%d", port))
+	if err != nil {
+		log.Fatalf("grpc failed to listen: %v", err)
+	}
+
+	s := grpc.NewServer()
+	healthpb.RegisterHealthServer(s, &healthServer{})
+
+	log.Printf("grpc listening on port %d", port)
+	if err := s.Serve(lis); err != nil {
+		log.Fatalf("grpc failed to serve: %v", err)
+	}
+}
+
+func (s *healthServer) Check(ctx context.Context, in *healthpb.HealthCheckRequest) (*healthpb.HealthCheckResponse, error) {
+	if !readinessEnabled {
+		return &healthpb.HealthCheckResponse{Status: healthpb.HealthCheckResponse_UNKNOWN}, grpc.Errorf(codes.FailedPrecondition, "readiness not enabled")
+	}
+
+	if isHealthy {
+		return &healthpb.HealthCheckResponse{Status: healthpb.HealthCheckResponse_SERVING}, nil
+	} else {
+		return &healthpb.HealthCheckResponse{Status: healthpb.HealthCheckResponse_NOT_SERVING}, nil
+	}
+}
+
 func cache() error {
 	var sortedInstances []InstanceView
 	var sortedString []string
diff --git a/run/testing/service_health.e2e_test.go b/run/testing/service_health.e2e_test.go
index fb40424972..f409a9448f 100644
--- a/run/testing/service_health.e2e_test.go
+++ b/run/testing/service_health.e2e_test.go
@@ -26,7 +26,7 @@ import (
 	"github.com/GoogleCloudPlatform/golang-samples/internal/testutil"
 )
 
-func TestServiceHealth(t *testing.T) {
+func TestServiceHealthHttp(t *testing.T) {
 	tc := testutil.EndToEndTest(t)
 
 	service := cloudrunci.NewService("service-health", tc.ProjectID)
@@ -86,3 +86,63 @@ func TestServiceHealth(t *testing.T) {
 		t.Fatalf("testutil.DeleteBucketIfExists: %v", err)
 	}
 }
+
+func TestServiceHealthGrpc(t *testing.T) {
+	tc := testutil.EndToEndTest(t)
+
+	service := cloudrunci.NewService("service-health", tc.ProjectID)
+	service.Readiness = &cloudrunci.ReadinessProbe{
+		TimeoutSeconds:   1,
+		PeriodSeconds:    1,
+		SuccessThreshold: 1,
+		FailureThreshold: 1,
+		GRPC: &cloudrunci.GRPCProbe{
+			Port: 8081,
+		},
+	}
+	service.Dir = "../service-health"
+	service.AsBuildpack = true
+	service.Platform.CommandFlags()
+
+	if err := service.Deploy(); err != nil {
+		t.Fatalf("service.Deploy %q: %v", service.Name, err)
+	}
+	defer func(service *cloudrunci.Service) {
+		err := service.Clean()
+		if err != nil {
+			t.Fatalf("service.Clean %q: %v", service.Name, err)
+		}
+	}(service)
+
+	resp, err := service.Request("GET", "/are_you_ready")
+	if err != nil {
+		t.Fatalf("request: %v", err)
+	}
+
+	out, err := io.ReadAll(resp.Body)
+	if err != nil {
+		t.Fatalf("io.ReadAll: %v", err)
+	}
+
+	if got, want := string(out), "HEALTHY"; got != want {
+		t.Errorf("body: got %q, want %q", got, want)
+	}
+
+	if got := resp.StatusCode; got != http.StatusOK {
+		t.Errorf("response status: got %d, want %d", got, http.StatusOK)
+	}
+
+	ctx := context.Background()
+	c, err := storage.NewClient(ctx)
+	if err != nil {
+		t.Fatalf("storage.NewClient: %v", err)
+	}
+	defer c.Close()
+	bucketName := os.Getenv("GOLANG_SAMPLES_PROJECT_ID") + "-" + service.Version()
+	t.Logf("Deleting bucket: %s", bucketName)
+
+	err = testutil.DeleteBucketIfExists(ctx, c, bucketName)
+	if err != nil {
+		t.Fatalf("testutil.DeleteBucketIfExists: %v", err)
+	}
+}