diff --git a/packages/cli/src/cli/commands/doctor-release/theme/index.test.ts b/packages/cli/src/cli/commands/doctor-release/theme/index.test.ts
new file mode 100644
index 0000000000..71cb3012c4
--- /dev/null
+++ b/packages/cli/src/cli/commands/doctor-release/theme/index.test.ts
@@ -0,0 +1,47 @@
+import DoctorReleaseTheme from './index.js'
+import {runThemeDoctor} from '../../../services/doctor-release/theme/runner.js'
+import {renderConfirmationPrompt} from '@shopify/cli-kit/node/ui'
+import {afterEach, expect, test, vi} from 'vitest'
+
+vi.mock('@shopify/cli-kit/node/ui')
+vi.mock('../../../services/doctor-release/theme/runner.js')
+
+afterEach(() => {
+  vi.unstubAllEnvs()
+})
+
+test('does not run theme doctor when user cancels', async () => {
+  // Given
+  vi.stubEnv('SHOPIFY_CLI_DOCTOR', '1')
+  vi.mocked(renderConfirmationPrompt).mockResolvedValue(false)
+
+  // When
+  await DoctorReleaseTheme.run(['--environment', 'test'])
+
+  // Then
+  expect(runThemeDoctor).not.toHaveBeenCalled()
+})
+
+test('runs theme doctor when user confirms', async () => {
+  // Given
+  vi.stubEnv('SHOPIFY_CLI_DOCTOR', '1')
+  vi.mocked(renderConfirmationPrompt).mockResolvedValue(true)
+  vi.mocked(runThemeDoctor).mockResolvedValue([])
+
+  // When
+  await DoctorReleaseTheme.run(['--environment', 'test'])
+
+  // Then
+  expect(runThemeDoctor).toHaveBeenCalled()
+})
+
+test('does not run theme doctor when environment variable is not set', async () => {
+  // Given - no SHOPIFY_CLI_DOCTOR env var set
+
+  // When
+  await DoctorReleaseTheme.run(['--environment', 'test'])
+
+  // Then - neither prompt nor doctor should be called
+  expect(renderConfirmationPrompt).not.toHaveBeenCalled()
+  expect(runThemeDoctor).not.toHaveBeenCalled()
+})
diff --git a/packages/cli/src/cli/commands/doctor-release/theme/index.ts b/packages/cli/src/cli/commands/doctor-release/theme/index.ts
index 026a1f0eea..576bd325fa 100644
--- a/packages/cli/src/cli/commands/doctor-release/theme/index.ts
+++ b/packages/cli/src/cli/commands/doctor-release/theme/index.ts
@@ -4,6 +4,7 @@ import {globalFlags} from '@shopify/cli-kit/node/cli'
 import {Flags} from '@oclif/core'
 import {resolvePath, cwd} from '@shopify/cli-kit/node/path'
 import {canRunDoctorRelease} from '@shopify/cli-kit/node/context/local'
+import {renderConfirmationPrompt, RenderConfirmationPromptOptions} from '@shopify/cli-kit/node/ui'
 
 export default class DoctorReleaseTheme extends Command {
   static description = 'Run all theme command doctor-release tests'
@@ -39,7 +40,16 @@ export default class DoctorReleaseTheme extends Command {
     if (!canRunDoctorRelease()) {
       return
     }
+    const promptOptions: RenderConfirmationPromptOptions = {
+      message: `This will run automated theme commands against your shop. It will modify remote themes. Please confirm before running.`,
+      confirmationMessage: 'Yes I understand',
+      cancellationMessage: 'No, cancel the command',
+    }
+    const confirmed = await renderConfirmationPrompt(promptOptions)
 
+    if (!confirmed) {
+      return
+    }
     const {flags} = await this.parse(DoctorReleaseTheme)
 
     const results = await runThemeDoctor({