diff --git a/litellm/proxy/health_endpoints/_health_endpoints.py b/litellm/proxy/health_endpoints/_health_endpoints.py
index 4496ad92631..0d06eae3ee7 100644
--- a/litellm/proxy/health_endpoints/_health_endpoints.py
+++ b/litellm/proxy/health_endpoints/_health_endpoints.py
@@ -33,6 +33,7 @@ from litellm.proxy.health_check import (
     perform_health_check,
     run_with_timeout,
 )
+from litellm.proxy.health_endpoints.backlog_health import BacklogHealth
 from litellm.secret_managers.main import get_secret
 
 #### Health ENDPOINTS ####
@@ -1130,7 +1131,6 @@ async def _db_health_readiness_check():
         PrismaDBExceptionHandler.handle_db_exception(e)
         return db_health_cache
 
-
 @router.get(
     "/settings",
     tags=["health"],
@@ -1297,6 +1297,20 @@ async def health_readiness():
         raise HTTPException(status_code=503, detail=f"Service Unhealthy ({str(e)})")
 
 
+@router.get(
+    "/health/backlog",
+    tags=["health"],
+    dependencies=[Depends(user_api_key_auth)],
+)
+async def health_backlog(
+    port: Optional[int] = fastapi.Query(
+        None, description="Port to inspect. Defaults to PORT env var or 4000."
+    ),
+):
+    resolved_port = port or int(os.getenv("PORT", "4000"))
+    return BacklogHealth.get_cached_listen_queue_stats(port=resolved_port)
+
+
 @router.get(
     "/health/liveliness",  # Historical LiteLLM name; doesn't match k8s terminology but kept for backwards compatibility
     tags=["health"],
@@ -1329,6 +1343,23 @@ async def health_readiness_options():
     return Response(headers=response_headers, status_code=200)
 
 
+@router.options(
+    "/health/backlog",
+    tags=["health"],
+    dependencies=[Depends(user_api_key_auth)],
+)
+async def health_backlog_options():
+    """
+    Options endpoint for health/backlog check.
+    """
+    response_headers = {
+        "Allow": "GET, OPTIONS",
+        "Access-Control-Allow-Methods": "GET, OPTIONS",
+        "Access-Control-Allow-Headers": "*",
+    }
+    return Response(headers=response_headers, status_code=200)
+
+
 @router.options(
     "/health/liveliness",
     tags=["health"],
diff --git a/tests/test_litellm/proxy/health_endpoints/test_health_endpoints.py b/tests/test_litellm/proxy/health_endpoints/test_health_endpoints.py
index cc6302644a7..81ea6c12ebf 100644
--- a/tests/test_litellm/proxy/health_endpoints/test_health_endpoints.py
+++ b/tests/test_litellm/proxy/health_endpoints/test_health_endpoints.py
@@ -23,6 +23,7 @@ from litellm.proxy.health_endpoints._health_endpoints import (
 from litellm.proxy.health_endpoints._health_endpoints import (
     test_model_connection as health_test_model_connection,
 )
+from litellm.proxy.health_endpoints.backlog_health import BacklogHealth
 
 # Import shared proxy test helpers from conftest
 from tests.test_litellm.proxy.conftest import create_proxy_test_client
@@ -481,6 +482,72 @@ def test_health_readiness(proxy_client):
     print("="*60 + "\n")
 
 
+def test_parse_linux_ss_listen_queue():
+    sample_output = """State  Recv-Q Send-Q Local Address:Port  Peer Address:Port
+LISTEN 3      128    0.0.0.0:4000        0.0.0.0:*
+"""
+    result = BacklogHealth.parse_linux_ss_listen_queue(output=sample_output, port=4000)
+    assert result["listen_queue_current"] == 3
+    assert result["listen_queue_max"] == 128
+
+
+def test_parse_macos_netstat_listen_queue():
+    sample_output = """Current listen queue sizes (qlen/incqlen/maxqlen)
+tcp4       2/0/128      *.4000               *.*                    LISTEN
+"""
+    result = BacklogHealth.parse_macos_netstat_listen_queue(
+        output=sample_output, port=4000
+    )
+    assert result["listen_queue_current"] == 2
+    assert result["listen_queue_max"] == 128
+
+
+def test_get_cached_listen_queue_stats_uses_cache():
+    mock_stats = {
+        "status": "healthy",
+        "port": 4000,
+        "listen_queue_current": 1,
+        "listen_queue_max": 128,
+        "listen_queue_utilization": 0.0078,
+        "listen_queue_status": "ok",
+        "sampled_at": "2026-02-26T00:00:00Z",
+    }
+    BacklogHealth.cache = {"last_updated": datetime.min, "port": None, "data": None}
+    with patch(
+        "litellm.proxy.health_endpoints.backlog_health.BacklogHealth.read_listen_queue_stats_for_port",
+        return_value=mock_stats,
+    ) as mock_reader:
+        first = BacklogHealth.get_cached_listen_queue_stats(port=4000, ttl_seconds=30)
+        second = BacklogHealth.get_cached_listen_queue_stats(port=4000, ttl_seconds=30)
+
+    assert first == second
+    assert mock_reader.call_count == 1
+
+
+def test_health_backlog_endpoint(proxy_client):
+    mock_stats = {
+        "status": "healthy",
+        "port": 4000,
+        "source": "ss",
+        "listen_queue_current": 7,
+        "listen_queue_max": 128,
+        "listen_queue_utilization": 0.0547,
+        "listen_queue_status": "ok",
+        "sampled_at": "2026-02-26T00:00:00Z",
+    }
+    with patch(
+        "litellm.proxy.health_endpoints._health_endpoints.BacklogHealth.get_cached_listen_queue_stats",
+        return_value=mock_stats,
+    ):
+        response = proxy_client.get("/health/backlog")
+
+    assert response.status_code == 200
+    payload = response.json()
+    assert payload["status"] == "healthy"
+    assert payload["listen_queue_current"] == 7
+    assert payload["listen_queue_max"] == 128
+
+
 def test_get_callback_identifier_string_and_object_with_callback_name():
     """
     Test get_callback_identifier with string callbacks and objects with callback_name attribute.