diff --git a/create-db/README.md b/create-db/README.md
index b382485..a308958 100644
--- a/create-db/README.md
+++ b/create-db/README.md
@@ -78,11 +78,14 @@ npx create-db -i -e .env
 
 # List available regions
 npx create-db regions
+
+# List available regions as JSON
+npx create-db regions --json
 ```
 
 ### JSON Output
 
-When using `--json`, the output includes:
+When using `--json` with `create`, the output includes:
 
 ```json
 {
@@ -96,6 +99,18 @@ When using `--json`, the output includes:
 }
 ```
 
+When using `--json` with `regions`, the output is an array of region objects:
+
+```json
+[
+  {
+    "id": "us-east-1",
+    "name": "US East (N. Virginia)",
+    "status": "available"
+  }
+]
+```
+
 ### Environment File Output
 
 When using `--env`, the following variables are appended to the specified file:
diff --git a/create-db/__tests__/cli.test.ts b/create-db/__tests__/cli.test.ts
index a5b0c62..aa0e6b8 100644
--- a/create-db/__tests__/cli.test.ts
+++ b/create-db/__tests__/cli.test.ts
@@ -65,6 +65,7 @@ describe("CLI help and version", () => {
     const result = await runCli(["regions", "--help"]);
     expect(result.exitCode).toBe(0);
     expect(result.all).toContain("List available Prisma Postgres regions");
+    expect(result.all).toContain("--json");
   });
 });
 
diff --git a/create-db/__tests__/create.test.ts b/create-db/__tests__/create.test.ts
index 33116a6..0bb113e 100644
--- a/create-db/__tests__/create.test.ts
+++ b/create-db/__tests__/create.test.ts
@@ -77,4 +77,21 @@ describe("CLI database creation", () => {
     }
     expect(allOutput).toContain("Available Prisma Postgres regions");
   }, 20000);
+
+  it("lists regions as JSON with regions --json", async () => {
+    const result = await runCli(["regions", "--json"]);
+    if (result.exitCode !== 0) {
+      console.error("CLI failed with exit code:", result.exitCode);
+      console.error("stdout:", result.stdout);
+      console.error("stderr:", result.stderr);
+    }
+    expect(result.exitCode).toBe(0);
+    const trimmed = result.stdout.trim();
+    expect(trimmed).toMatch(/^\s*\[/);
+    const parsed = JSON.parse(trimmed);
+    expect(Array.isArray(parsed)).toBe(true);
+    expect(parsed.length).toBeGreaterThan(0);
+    expect(parsed[0]).toHaveProperty("id");
+    expect(parsed[0]).toHaveProperty("status");
+  }, 20000);
 });
diff --git a/create-db/__tests__/flags.test.ts b/create-db/__tests__/flags.test.ts
index 8071562..f133cff 100644
--- a/create-db/__tests__/flags.test.ts
+++ b/create-db/__tests__/flags.test.ts
@@ -1,5 +1,10 @@
 import { describe, it, expect } from "vitest";
-import { CreateFlags, type CreateFlagsInput } from "../src/cli/flags.js";
+import {
+  CreateFlags,
+  RegionsFlags,
+  type CreateFlagsInput,
+  type RegionsFlagsInput,
+} from "../src/cli/flags.js";
 import { RegionSchema } from "../src/types.js";
 
 describe("CreateFlags schema", () => {
@@ -219,3 +224,27 @@ describe("RegionSchema", () => {
     expect(RegionSchema.safeParse({}).success).toBe(false);
   });
 });
+
+describe("RegionsFlags schema", () => {
+  it("defaults json to false", () => {
+    const result = RegionsFlags.safeParse({});
+    expect(result.success).toBe(true);
+    if (result.success) {
+      expect(result.data.json).toBe(false);
+    }
+  });
+
+  it("accepts json=true", () => {
+    const result = RegionsFlags.safeParse({ json: true });
+    expect(result.success).toBe(true);
+    if (result.success) {
+      expect(result.data.json).toBe(true);
+    }
+  });
+
+  it("infers RegionsFlagsInput correctly", () => {
+    const input: RegionsFlagsInput = { json: true };
+    const result = RegionsFlags.parse(input);
+    expect(result.json).toBe(true);
+  });
+});
diff --git a/create-db/src/cli/commands/regions.ts b/create-db/src/cli/commands/regions.ts
index 2049148..e2f1347 100644
--- a/create-db/src/cli/commands/regions.ts
+++ b/create-db/src/cli/commands/regions.ts
@@ -1,11 +1,18 @@
 import { log } from "@clack/prompts";
 import pc from "picocolors";
 
+import type { RegionsFlagsInput } from "../flags.js";
 import { fetchRegions } from "../../core/services.js";
+import { printJson } from "../output.js";
 
-export async function handleRegions(): Promise<void> {
+export async function handleRegions(input: RegionsFlagsInput): Promise<void> {
   const regions = await fetchRegions();
 
+  if (input.json) {
+    printJson(regions);
+    return;
+  }
+
   log.message("");
   log.info(pc.bold(pc.cyan("Available Prisma Postgres regions:")));
   log.message("");
diff --git a/create-db/src/cli/flags.ts b/create-db/src/cli/flags.ts
index 356fca5..dc90549 100644
--- a/create-db/src/cli/flags.ts
+++ b/create-db/src/cli/flags.ts
@@ -35,4 +35,19 @@ export const CreateFlags = z.object({
 /** Inferred type from CreateFlags schema. */
 export type CreateFlagsInput = z.infer<typeof CreateFlags>;
 
-// GitHub issue to suppress the Alias in the help text: https://github.com/mmkal/trpc-cli/issues/154
\ No newline at end of file
+/**
+ * Zod schema for CLI flags used by the `regions` command.
+ */
+export const RegionsFlags = z.object({
+  json: z
+    .boolean()
+    .optional()
+    .default(false)
+    .describe("Output machine-readable JSON")
+    .meta({ alias: "j" }),
+});
+
+/** Inferred type from RegionsFlags schema. */
+export type RegionsFlagsInput = z.infer<typeof RegionsFlags>;
+
+// GitHub issue to suppress the Alias in the help text: https://github.com/mmkal/trpc-cli/issues/154
diff --git a/create-db/src/index.ts b/create-db/src/index.ts
index 0214b14..b854318 100644
--- a/create-db/src/index.ts
+++ b/create-db/src/index.ts
@@ -6,7 +6,10 @@ import {
   type CreateDatabaseResult,
   type ProgrammaticCreateOptions,
 } from "./types.js";
-import { CreateFlags } from "./cli/flags.js";
+import {
+  CreateFlags,
+  RegionsFlags,
+} from "./cli/flags.js";
 import { getCommandName } from "./core/database.js";
 import { handleCreate, handleRegions } from "./cli/commands/index.js";
 import { createDatabase, fetchRegions } from "./core/services.js";
@@ -21,7 +24,12 @@ export type {
 } from "./types.js";
 
 export { isDatabaseError, isDatabaseSuccess, RegionSchema } from "./types.js";
-export { CreateFlags, type CreateFlagsInput } from "./cli/flags.js";
+export {
+  CreateFlags,
+  RegionsFlags,
+  type CreateFlagsInput,
+  type RegionsFlagsInput,
+} from "./cli/flags.js";
 
 const router = os.router({
   create: os
@@ -34,7 +42,8 @@ const router = os.router({
 
   regions: os
     .meta({ description: "List available Prisma Postgres regions" })
-    .handler(async () => handleRegions()),
+    .input(RegionsFlags)
+    .handler(async ({ input }) => handleRegions(input)),
 });
 
 /**