diff --git a/litellm-proxy-extras/migration_runbook.md b/litellm-proxy-extras/migration_runbook.md
new file mode 100644
index 0000000000..93948f24b1
--- /dev/null
+++ b/litellm-proxy-extras/migration_runbook.md
@@ -0,0 +1,50 @@
+# Database Migration Runbook
+
+This is a runbook for creating and running database migrations for the LiteLLM proxy. For use for litellm engineers only.
+
+## Quick Start
+
+```bash
+# Install deps (one time)
+pip install testing.postgresql
+brew install postgresql@14  # macOS
+
+# Add to PATH
+export PATH="/opt/homebrew/opt/postgresql@14/bin:$PATH"
+
+# Run migration
+python ci_cd/run_migration.py "your_migration_name"
+```
+
+## What It Does
+
+1. Creates temp PostgreSQL DB
+2. Applies existing migrations
+3. Compares with `schema.prisma`
+4. Generates new migration if changes found
+
+## Common Fixes
+
+**Missing testing module:**
+```bash
+pip install testing.postgresql
+```
+
+**initdb not found:**
+```bash
+brew install postgresql@14
+export PATH="/opt/homebrew/opt/postgresql@14/bin:$PATH"
+```
+
+**Empty migration directory error:**
+```bash
+rm -rf litellm-proxy-extras/litellm_proxy_extras/migrations/[empty_dir]
+```
+
+## Rules
+
+- Update `schema.prisma` first
+- Review generated SQL before committing
+- Use descriptive migration names
+- Never edit existing migration files
+- Commit schema + migration together