diff --git a/infrastructure/modules/container-apps/alerts.tf b/infrastructure/modules/container-apps/alerts.tf
index a9ea412bd..111094fe5 100644
--- a/infrastructure/modules/container-apps/alerts.tf
+++ b/infrastructure/modules/container-apps/alerts.tf
@@ -36,3 +36,56 @@ resource "azurerm_monitor_scheduled_query_rules_alert_v2" "failure_event" {
     }
   }
 }
+
+# IMPORTANT:
+# Enable metrics store with all dimensions: https://docs.azure.cn/en-us/azure-monitor/app/metrics-overview?tabs=standard#custom-metrics-dimensions-and-preaggregation
+# currently this feature is in preview.
+resource "azurerm_monitor_scheduled_query_rules_alert_v2" "queue_length_high" {
+  for_each = var.enable_alerting ? toset([
+    "notifications-message-status-updates",
+    "notifications-message-batch-retries"
+  ]) : []
+
+  name                = "${var.app_short_name}-${each.key}-${var.environment}-queue-length-high-alert"
+  location            = var.region
+  resource_group_name = azurerm_resource_group.main.name
+
+  auto_mitigation_enabled = true
+  description             = "Alert when queue length exceeds ${var.queue_length_alert_threshold}"
+  display_name            = "${var.app_short_name} Notifications Queue Length High Alert"
+  enabled                 = true
+  severity                = 2
+  evaluation_frequency    = "PT10M"
+  window_duration         = "PT10M"
+  scopes                  = [var.app_insights_id]
+
+  criteria {
+    query = <<-KQL
+      customMetrics
+      | where name == "${each.key}"
+      | extend environment = tostring(customDimensions.environment)
+      | where environment == "${var.environment}"
+      | extend value = toreal(value)
+      | summarize avg_value = avg(value) by bin(timestamp, 5m)
+      | where avg_value > ${var.queue_length_alert_threshold}
+    KQL
+
+    metric_measure_column   = "avg_value"
+    time_aggregation_method = "Average"
+    operator  = "GreaterThan"
+    threshold = 0
+
+    failing_periods {
+      minimum_failing_periods_to_trigger_alert = 1
+      number_of_evaluation_periods             = 1
+    }
+  }
+
+  action {
+    action_groups = [var.action_group_id]
+  }
+
+  tags = {
+    environment = var.environment
+  }
+}
diff --git a/infrastructure/modules/container-apps/jobs.tf b/infrastructure/modules/container-apps/jobs.tf
index 556a0ad7f..681d972ab 100644
--- a/infrastructure/modules/container-apps/jobs.tf
+++ b/infrastructure/modules/container-apps/jobs.tf
@@ -17,6 +17,7 @@ locals {
       job_container_args = "create_appointments"
     }
     send_message_batch = {
+
       # cron_expression = "0,30 9 * * 1-5"
       cron_expression = null
       environment_variables = {
@@ -43,6 +44,7 @@ locals {
       cron_expression = null
       environment_variables = {
         STATUS_UPDATES_QUEUE_NAME = "notifications-message-status-updates"
+        ENVIRONMENT               = var.environment
       }
       job_short_name     = "sms"
       job_container_args = "save_message_status"
@@ -64,6 +66,16 @@ locals {
       job_short_name     = "smk"
       job_container_args = "create_reports --smoke-test"
     }
+    collect_metrics = {
+      cron_expression = "*/5 * * * *"
+      environment_variables = {
+        RETRY_QUEUE_NAME          = "notifications-message-batch-retries"
+        STATUS_UPDATES_QUEUE_NAME = "notifications-message-status-updates"
+        ENVIRONMENT               = var.environment
+      }
+      job_short_name     = "clm"
+      job_container_args = "collect_metrics"
+    }
   }
 }
 
diff --git a/infrastructure/modules/container-apps/variables.tf b/infrastructure/modules/container-apps/variables.tf
index e7f1f9120..c48166817 100644
--- a/infrastructure/modules/container-apps/variables.tf
+++ b/infrastructure/modules/container-apps/variables.tf
@@ -200,6 +200,11 @@ variable "app_insights_id" {
   type        = string
 }
 
+variable "queue_length_alert_threshold" {
+  description = "If alerting is enabled, alert if storage account queues are greater than this threshold."
+  type        = number
+}
+
 variable "enable_notifications_jobs_schedule" {
   description = "Whether we apply the cron schedules for the notifications container app jobs"
   type        = bool
diff --git a/infrastructure/terraform/main.tf b/infrastructure/terraform/main.tf
index 22d1f1a2a..d909dd7fb 100644
--- a/infrastructure/terraform/main.tf
+++ b/infrastructure/terraform/main.tf
@@ -78,4 +78,5 @@ module "container-apps" {
   target_url                            = var.deploy_container_apps ? "${module.container-apps[0].external_url}healthcheck" : null
   resource_group_name_infra             = local.resource_group_name
   enable_notifications_jobs_schedule    = var.enable_notifications_jobs_schedule
+  queue_length_alert_threshold          = var.queue_length_alert_threshold
 }
diff --git a/infrastructure/terraform/variables.tf b/infrastructure/terraform/variables.tf
index cd6e78767..6ac36a1f8 100644
--- a/infrastructure/terraform/variables.tf
+++ b/infrastructure/terraform/variables.tf
@@ -184,6 +184,12 @@ variable "run_notifications_smoke_test" {
   type        = bool
 }
 
+variable "queue_length_alert_threshold" {
+  description = "If alerting is enabled, alert if storage account queues are greater than this threshold."
+  type        = number
+  default     = 5
+}
+
 locals {
   region = "uksouth"
 
diff --git a/manage_breast_screening/notifications/management/commands/collect_metrics.py b/manage_breast_screening/notifications/management/commands/collect_metrics.py
new file mode 100644
index 000000000..b6f1ac90b
--- /dev/null
+++ b/manage_breast_screening/notifications/management/commands/collect_metrics.py
@@ -0,0 +1,25 @@
+import logging
+
+from django.core.management.base import BaseCommand, CommandError
+
+from manage_breast_screening.notifications.services.metrics import Metrics
+from manage_breast_screening.notifications.services.queue import Queue
+
+logger = logging.getLogger(__name__)
+
+
+class Command(BaseCommand):
+    def handle(self, *args, **options):
+        try:
+            # Set queue_size metrics
+            for queue in [Queue.RetryMessageBatches(), Queue.MessageStatusUpdates()]:
+                Metrics().set_gauge_value(
+                    f"queue_size_{queue.queue_name}",
+                    "messages",
+                    "Queue length",
+                    queue.get_message_count(),
+                )
+
+        except Exception as e:
+            logger.error(e, exc_info=True)
+            raise CommandError(e)
diff --git a/manage_breast_screening/notifications/services/metrics.py b/manage_breast_screening/notifications/services/metrics.py
new file mode 100644
index 000000000..1f075abe0
--- /dev/null
+++ b/manage_breast_screening/notifications/services/metrics.py
@@ -0,0 +1,50 @@
+import logging
+import os
+
+from azure.monitor.opentelemetry.exporter import AzureMonitorMetricExporter
+from opentelemetry import metrics
+from opentelemetry.sdk.metrics import MeterProvider
+from opentelemetry.sdk.metrics.export import PeriodicExportingMetricReader
+
+logger = logging.getLogger(__name__)
+
+
+class Metrics:
+    _instance = None
+
+    def __new__(cls, *args, **kwargs):
+        if cls._instance is None:
+            cls._instance = super().__new__(cls)
+        return cls._instance
+
+    def __init__(self):
+        environment = os.getenv("ENVIRONMENT")
+        logger.debug((f"Initialising Metrics(environment: {environment})"))
+
+        exporter = AzureMonitorMetricExporter(
+            connection_string=os.getenv("APPLICATIONINSIGHTS_CONNECTION_STRING")
+        )
+        metrics.set_meter_provider(
+            MeterProvider(metric_readers=[PeriodicExportingMetricReader(exporter)])
+        )
+        self.meter = metrics.get_meter(__name__)
+        self.environment = environment
+
+    def set_gauge_value(self, metric_name, units, description, value):
+        logger.debug(
+            (
+                f"Metrics: set_gauge_value(metric_name: {metric_name} "
+                f"units: {units}, description: {description}, value: {value})"
+            )
+        )
+
+        # Create gauge metric
+        gauge = self.meter.create_gauge(
+            metric_name, unit=units, description=description
+        )
+
+        # Set metric value
+        gauge.set(
+            value,
+            {"environment": self.environment},
+        )
diff --git a/manage_breast_screening/notifications/services/queue.py b/manage_breast_screening/notifications/services/queue.py
index edc294431..b31002590 100644
--- a/manage_breast_screening/notifications/services/queue.py
+++ b/manage_breast_screening/notifications/services/queue.py
@@ -1,9 +1,12 @@
+import logging
 import os
 
 from azure.core.exceptions import ResourceExistsError
 from azure.identity import ManagedIdentityCredential
 from azure.storage.queue import QueueClient, QueueMessage
 
+logger = logging.getLogger(__name__)
+
 
 class QueueConfigurationError(Exception):
     """Raised when queue is not properly configured"""
@@ -16,6 +19,7 @@ def __init__(self, queue_name):
         storage_account_name = os.getenv("STORAGE_ACCOUNT_NAME")
         queue_mi_client_id = os.getenv("QUEUE_MI_CLIENT_ID")
         connection_string = os.getenv("QUEUE_STORAGE_CONNECTION_STRING")
+        self.queue_name = queue_name
 
         if storage_account_name and queue_mi_client_id:
             self.client = QueueClient(
@@ -55,6 +59,9 @@ def peek(self):
     def item(self):
         return self.client.receive_message()
 
+    def get_message_count(self):
+        return self.client.get_queue_properties().approximate_message_count
+
     @classmethod
     def MessageStatusUpdates(cls):
         return cls(
diff --git a/manage_breast_screening/notifications/tests/management/commands/test_collect_metrics.py b/manage_breast_screening/notifications/tests/management/commands/test_collect_metrics.py
new file mode 100644
index 000000000..511874678
--- /dev/null
+++ b/manage_breast_screening/notifications/tests/management/commands/test_collect_metrics.py
@@ -0,0 +1,46 @@
+from unittest.mock import MagicMock, patch
+
+import pytest
+
+from manage_breast_screening.notifications.management.commands.collect_metrics import (
+    Command,
+)
+
+
+class TestCollectMetrics:
+    @pytest.fixture(autouse=True)
+    def setup(self, monkeypatch):
+        monkeypatch.setenv("ENVIRONMENT", "test")
+
+    @patch(f"{Command.__module__}.Queue")
+    @patch(f"{Command.__module__}.Metrics")
+    def test_handle_sends_queue_lengths(self, mock_metrics_class, mock_queue):
+        mock_retry = MagicMock()
+        mock_retry.queue_name = "retry_queue"
+        mock_retry.get_message_count.return_value = 8
+
+        mock_status = MagicMock()
+        mock_status.queue_name = "status_queue"
+        mock_status.get_message_count.return_value = 2
+
+        mock_queue.RetryMessageBatches.return_value = mock_retry
+        mock_queue.MessageStatusUpdates.return_value = mock_status
+
+        Command().handle()
+
+        metrics_instance = mock_metrics_class.return_value
+
+        metrics_instance.set_gauge_value.assert_any_call(
+            "queue_size_retry_queue",
+            "messages",
+            "Queue length",
+            8,
+        )
+        metrics_instance.set_gauge_value.assert_any_call(
+            "queue_size_status_queue",
+            "messages",
+            "Queue length",
+            2,
+        )
+
+        assert metrics_instance.set_gauge_value.call_count == 2
diff --git a/manage_breast_screening/notifications/tests/services/test_metrics.py b/manage_breast_screening/notifications/tests/services/test_metrics.py
new file mode 100644
index 000000000..b6d033163
--- /dev/null
+++ b/manage_breast_screening/notifications/tests/services/test_metrics.py
@@ -0,0 +1,92 @@
+from unittest.mock import MagicMock, patch
+
+import pytest
+
+from manage_breast_screening.notifications.services.metrics import Metrics
+
+
+@patch(f"{Metrics.__module__}.AzureMonitorMetricExporter")
+@patch(f"{Metrics.__module__}.PeriodicExportingMetricReader")
+@patch(f"{Metrics.__module__}.metrics")
+@patch(f"{Metrics.__module__}.MeterProvider")
+class TestMetrics:
+    @pytest.fixture
+    def conn_string(self):
+        return "InstrumentationKey=00000000-0000-0000-0000-000000000000"
+
+    @pytest.fixture(autouse=True)
+    def setup(self, monkeypatch, conn_string):
+        monkeypatch.setenv("APPLICATIONINSIGHTS_CONNECTION_STRING", conn_string)
+        monkeypatch.setenv("ENVIRONMENT", "dev")
+
+    def test_metrics_initialisation(
+        self,
+        mock_meter_provider,
+        mock_metrics,
+        mock_metric_reader,
+        mock_metric_exporter,
+        conn_string,
+    ):
+        mock_meter = MagicMock()
+        mock_metrics.get_meter.return_value = mock_meter
+
+        subject = Metrics()
+
+        mock_metric_exporter.assert_called_once_with(connection_string=str(conn_string))
+        mock_metric_reader.assert_called_once_with(mock_metric_exporter.return_value)
+        mock_meter_provider.assert_called_once_with(
+            metric_readers=[mock_metric_reader.return_value]
+        )
+        mock_metrics.set_meter_provider.assert_called_once_with(
+            mock_meter_provider.return_value
+        )
+        mock_metrics.get_meter.assert_called_once_with(
+            "manage_breast_screening.notifications.services.metrics"
+        )
+
+        assert subject.meter == mock_meter
+        assert subject.environment == "dev"
+
+    def test_metrics_is_a_singleton(
+        self,
+        mock_meter_provider,
+        mock_metrics,
+        mock_reader,
+        mock_exporter,
+    ):
+        subject = Metrics()
+        the_same_instance = Metrics()
+        assert subject == the_same_instance
+
+    def test_set_gauge_value(
+        self,
+        mock_meter_provider,
+        mock_metrics,
+        mock_reader,
+        mock_exporter,
+    ):
+        mock_meter = MagicMock()
+        mock_gauge = MagicMock()
+
+        mock_metrics.get_meter.return_value = mock_meter
+        mock_meter.create_gauge.return_value = mock_gauge
+
+        subject = Metrics()
+
+        subject.set_gauge_value(
+            metric_name="queue_depth",
+            units="messages",
+            description="Number of messages",
+            value=999,
+        )
+
+        mock_meter.create_gauge.assert_called_once_with(
+            "queue_depth",
+            unit="messages",
+            description="Number of messages",
+        )
+
+        mock_gauge.set.assert_called_once_with(
+            999,
+            {"environment": "dev"},
+        )
diff --git a/manage_breast_screening/notifications/tests/services/test_queue.py b/manage_breast_screening/notifications/tests/services/test_queue.py
index 67ef4445f..d8c4e939e 100644
--- a/manage_breast_screening/notifications/tests/services/test_queue.py
+++ b/manage_breast_screening/notifications/tests/services/test_queue.py
@@ -1,4 +1,4 @@
-from unittest.mock import MagicMock, patch
+from unittest.mock import MagicMock, PropertyMock, patch
 
 import pytest
 
@@ -150,3 +150,15 @@ def test_queue_raises_configuration_error_when_no_config_provided(
             Queue("test-queue")
 
         assert "Queue not configured" in str(exc_info.value)
+
+    def test_get_message_count_returns_correct_value(self, mock_queue_client, caplog):
+        with patch(
+            "manage_breast_screening.notifications.services.queue.QueueClient"
+        ) as queue_client:
+            queue_client.get_queue_properties.return_value = PropertyMock(
+                approximate_message_count=666
+            )
+            subject = Queue("A-Q")
+            subject.client = queue_client
+
+            assert subject.get_message_count() == 666