diff --git a/docs/deployment/k8s.md b/docs/deployment/k8s.md
index dbcb277278c..7a92c99b2c4 100644
--- a/docs/deployment/k8s.md
+++ b/docs/deployment/k8s.md
@@ -4,6 +4,7 @@ Deploying vLLM on Kubernetes is a scalable and efficient way to serve machine le
 
 - [Deployment with CPUs](#deployment-with-cpus)
 - [Deployment with GPUs](#deployment-with-gpus)
+- [Serving with gRPC](#serving-with-grpc)
 - [Troubleshooting](#troubleshooting)
     - [Startup Probe or Readiness Probe Failure, container log contains "KeyboardInterrupt: terminated"](#startup-probe-or-readiness-probe-failure-container-log-contains-keyboardinterrupt-terminated)
 - [Conclusion](#conclusion)
@@ -387,6 +388,49 @@ INFO:     Uvicorn running on http://0.0.0.0:8000 (Press CTRL+C to quit)
 
       If the service is correctly deployed, you should receive a response from the vLLM model.
 
+## Serving with gRPC
+
+vLLM can serve models over gRPC instead of HTTP by passing the `--grpc` flag. This requires the optional gRPC dependencies:
+
+```bash
+pip install vllm[grpc]
+```
+
+When using `--grpc`, the server exposes the standard [gRPC Health Checking Protocol](https://github.com/grpc/grpc/blob/master/doc/health-checking.md) (`grpc.health.v1.Health`), which integrates with Kubernetes [native gRPC probes](https://kubernetes.io/docs/tasks/configure-pod-container/configure-liveness-readiness-startup-probes/#define-a-grpc-liveness-probe) (available since Kubernetes 1.24).
+
+To deploy with gRPC, change the `vllm serve` command to include `--grpc` and replace `httpGet` probes with `grpc` probes:
+
+```yaml
+containers:
+- name: mistral-7b
+  image: vllm/vllm-openai:latest
+  command: ["/bin/sh", "-c"]
+  args: [
+    "pip install vllm[grpc] && vllm serve mistralai/Mistral-7B-Instruct-v0.3 --grpc --port 50051 --trust-remote-code"
+  ]
+  ports:
+  - containerPort: 50051
+  livenessProbe:
+    grpc:
+      port: 50051
+    initialDelaySeconds: 120
+    periodSeconds: 10
+  readinessProbe:
+    grpc:
+      port: 50051
+    initialDelaySeconds: 120
+    periodSeconds: 5
+```
+
+!!! note
+    The gRPC health service checks the engine status on every probe. If the engine is unhealthy or the server is shutting down, the probe returns `NOT_SERVING`.
+
+You can also verify the health service manually with `grpcurl`:
+
+```bash
+grpcurl -plaintext localhost:50051 grpc.health.v1.Health/Check
+```
+
 ## Troubleshooting
 
 ### Startup Probe or Readiness Probe Failure, container log contains "KeyboardInterrupt: terminated"
diff --git a/setup.py b/setup.py
index bb2d6ac545d..c05280e40e7 100644
--- a/setup.py
+++ b/setup.py
@@ -1107,7 +1107,7 @@ setup(
         #   - .buildkite/test-amd.yaml
         "helion": ["helion==1.0.0"],
         # Optional deps for gRPC server (vllm serve --grpc)
-        "grpc": ["smg-grpc-servicer[vllm] >= 0.5.0"],
+        "grpc": ["smg-grpc-servicer[vllm] >= 0.5.2"],
         # Optional deps for OpenTelemetry tracing
         "otel": [
             "opentelemetry-sdk>=1.26.0",
diff --git a/tests/entrypoints/test_grpc_health.py b/tests/entrypoints/test_grpc_health.py
new file mode 100644
index 00000000000..d63b8294c5f
--- /dev/null
+++ b/tests/entrypoints/test_grpc_health.py
@@ -0,0 +1,143 @@
+# SPDX-License-Identifier: Apache-2.0
+# SPDX-FileCopyrightText: Copyright contributors to the vLLM project
+from unittest.mock import AsyncMock, MagicMock, patch
+
+import pytest
+
+grpc = pytest.importorskip("grpc")
+health_pb2 = pytest.importorskip("grpc_health.v1.health_pb2")
+VllmHealthServicer = pytest.importorskip(
+    "smg_grpc_servicer.vllm.health_servicer"
+).VllmHealthServicer
+
+SERVING = health_pb2.HealthCheckResponse.SERVING
+NOT_SERVING = health_pb2.HealthCheckResponse.NOT_SERVING
+SERVICE_UNKNOWN = health_pb2.HealthCheckResponse.SERVICE_UNKNOWN
+
+
+@pytest.fixture
+def async_llm():
+    mock = MagicMock()
+    mock.check_health = AsyncMock()
+    return mock
+
+
+@pytest.fixture
+def context():
+    return MagicMock(spec=grpc.aio.ServicerContext)
+
+
+@pytest.fixture
+def servicer(async_llm):
+    return VllmHealthServicer(async_llm)
+
+
+@pytest.fixture
+def request_msg():
+    msg = MagicMock()
+    msg.service = ""
+    return msg
+
+
+# -- Check() tests --
+
+
+@pytest.mark.asyncio
+async def test_check_serving_overall(servicer, request_msg, context, async_llm):
+    request_msg.service = ""
+    response = await servicer.Check(request_msg, context)
+    assert response.status == SERVING
+    async_llm.check_health.assert_awaited_once()
+
+
+@pytest.mark.asyncio
+async def test_check_serving_vllm_service(servicer, request_msg, context, async_llm):
+    request_msg.service = "vllm.grpc.engine.VllmEngine"
+    response = await servicer.Check(request_msg, context)
+    assert response.status == SERVING
+    async_llm.check_health.assert_awaited_once()
+
+
+@pytest.mark.asyncio
+async def test_check_not_serving_engine_errored(
+    servicer, request_msg, context, async_llm
+):
+    async_llm.check_health = AsyncMock(side_effect=Exception("engine dead"))
+    request_msg.service = ""
+    response = await servicer.Check(request_msg, context)
+    assert response.status == NOT_SERVING
+
+
+@pytest.mark.asyncio
+async def test_check_not_serving_shutting_down(
+    servicer, request_msg, context, async_llm
+):
+    servicer.set_not_serving()
+    request_msg.service = ""
+    response = await servicer.Check(request_msg, context)
+    assert response.status == NOT_SERVING
+    async_llm.check_health.assert_not_awaited()
+
+
+@pytest.mark.asyncio
+async def test_check_unknown_service_status(servicer, request_msg, context):
+    request_msg.service = "nonexistent.Service"
+    response = await servicer.Check(request_msg, context)
+    assert response.status == SERVICE_UNKNOWN
+
+
+@pytest.mark.asyncio
+async def test_check_unknown_service_grpc_code(servicer, request_msg, context):
+    request_msg.service = "fake.Svc"
+    await servicer.Check(request_msg, context)
+    context.set_code.assert_called_once_with(grpc.StatusCode.NOT_FOUND)
+    context.set_details.assert_called_once()
+    details_arg = context.set_details.call_args[0][0]
+    assert "fake.Svc" in details_arg
+
+
+@pytest.mark.asyncio
+@patch("smg_grpc_servicer.vllm.health_servicer.logger")
+async def test_check_logs_exception_on_error(
+    mock_logger, servicer, request_msg, context, async_llm
+):
+    async_llm.check_health = AsyncMock(side_effect=Exception("engine exploded"))
+    request_msg.service = ""
+    await servicer.Check(request_msg, context)
+    mock_logger.exception.assert_called_once()
+    log_args = mock_logger.exception.call_args
+    assert "service" in str(log_args).lower()
+
+
+# -- Watch() tests --
+
+
+@pytest.mark.asyncio
+async def test_watch_yields_serving(servicer, request_msg, context, async_llm):
+    request_msg.service = ""
+    watch_iter = servicer.Watch(request_msg, context)
+    first = await anext(watch_iter.__aiter__())
+    assert first.status == SERVING
+
+
+@pytest.mark.asyncio
+async def test_watch_yields_not_serving(servicer, request_msg, context, async_llm):
+    async_llm.check_health = AsyncMock(side_effect=Exception("engine down"))
+    request_msg.service = ""
+    watch_iter = servicer.Watch(request_msg, context)
+    first = await anext(watch_iter.__aiter__())
+    assert first.status == NOT_SERVING
+
+
+@pytest.mark.asyncio
+async def test_watch_unknown_service(servicer, request_msg, context):
+    request_msg.service = "fake.Service"
+    results = []
+    async for response in servicer.Watch(request_msg, context):
+        results.append(response)
+    assert len(results) == 1
+    assert results[0].status == SERVICE_UNKNOWN
+    # Watch returns SERVICE_UNKNOWN in the response body (not as a gRPC error
+    # code) so the stream terminates normally -- unlike Check, which sets
+    # NOT_FOUND on the gRPC context for unknown services.
+    context.set_code.assert_not_called()
diff --git a/vllm/entrypoints/grpc_server.py b/vllm/entrypoints/grpc_server.py
index ddd8a5c50e4..b9173b302ca 100644
--- a/vllm/entrypoints/grpc_server.py
+++ b/vllm/entrypoints/grpc_server.py
@@ -26,8 +26,10 @@ import time
 
 try:
     import grpc
+    from grpc_health.v1 import health_pb2_grpc
     from grpc_reflection.v1alpha import reflection
     from smg_grpc_proto import vllm_engine_pb2, vllm_engine_pb2_grpc
+    from smg_grpc_servicer.vllm.health_servicer import VllmHealthServicer
     from smg_grpc_servicer.vllm.servicer import VllmEngineServicer
 except ImportError as e:
     raise ImportError(
@@ -98,9 +100,14 @@ async def serve_grpc(args: argparse.Namespace):
     # Add servicer to server
     vllm_engine_pb2_grpc.add_VllmEngineServicer_to_server(servicer, server)
 
+    # Add standard gRPC health service for Kubernetes probes
+    health_servicer = VllmHealthServicer(async_llm)
+    health_pb2_grpc.add_HealthServicer_to_server(health_servicer, server)
+
     # Enable reflection for grpcurl and other tools
     service_names = (
         vllm_engine_pb2.DESCRIPTOR.services_by_name["VllmEngine"].full_name,
+        "grpc.health.v1.Health",
         reflection.SERVICE_NAME,
     )
     reflection.enable_server_reflection(service_names, server)
@@ -147,6 +154,10 @@ async def serve_grpc(args: argparse.Namespace):
         logger.info("Shutting down vLLM gRPC server...")
         if stats_task is not None:
             stats_task.cancel()
+        try:
+            health_servicer.set_not_serving()
+        except Exception:  # broad: must not prevent server.stop() / shutdown()
+            logger.warning("Failed to set health status to NOT_SERVING", exc_info=True)
         await server.stop(grace=5.0)
         logger.info("gRPC server stopped")
         async_llm.shutdown()