diff --git a/src/codex/app-server-client.ts b/src/codex/app-server-client.ts
index aa40e13..bbc4243 100644
--- a/src/codex/app-server-client.ts
+++ b/src/codex/app-server-client.ts
@@ -481,6 +481,24 @@ export class CodexAppServerClient {
       }
     }
 
+    if (isMcpToolApprovalElicitation(parsed, method)) {
+      if (responseId !== null) {
+        this.send({
+          id: parsed.id,
+          result: buildMcpToolApprovalAcceptance(parsed),
+        });
+      }
+      this.emit({
+        event: "approval_auto_approved",
+        sessionId: this.currentTurn?.sessionId ?? null,
+        threadId: this.currentTurn?.threadId ?? this.threadId,
+        turnId: this.currentTurn?.turnId ?? null,
+        raw: parsed,
+        ...optionalTelemetry(this.lastUsage, this.lastRateLimits),
+      });
+      return;
+    }
+
     if (isApprovalRequest(parsed, method)) {
       if (responseId !== null) {
         this.send({
@@ -889,6 +907,62 @@ function isApprovalRequest(
   return containsStringValue(message, "approval");
 }
 
+function isMcpToolApprovalElicitation(
+  message: JsonObject,
+  method: string | null,
+): boolean {
+  if (method !== "mcpServer/elicitation/request") {
+    return false;
+  }
+
+  return (
+    extractNestedString(message, ["params", "_meta", "codex_approval_kind"]) ===
+    "mcp_tool_call"
+  );
+}
+
+function buildMcpToolApprovalAcceptance(message: JsonObject): JsonObject {
+  const persist = pickMcpToolApprovalPersist(message);
+  return {
+    action: "accept",
+    content: {},
+    ...(persist === null ? { _meta: null } : { _meta: { persist } }),
+  };
+}
+
+function pickMcpToolApprovalPersist(message: JsonObject): string | null {
+  let persist: unknown = message;
+  for (const segment of ["params", "_meta", "persist"]) {
+    if (
+      persist === null ||
+      typeof persist !== "object" ||
+      Array.isArray(persist)
+    ) {
+      persist = null;
+      break;
+    }
+    persist = (persist as JsonObject)[segment];
+  }
+
+  if (persist === "always" || persist === "session") {
+    return persist;
+  }
+
+  if (Array.isArray(persist)) {
+    const values = persist.filter(
+      (value): value is string => typeof value === "string",
+    );
+    if (values.includes("always")) {
+      return "always";
+    }
+    if (values.includes("session")) {
+      return "session";
+    }
+  }
+
+  return null;
+}
+
 function isToolCallRequest(
   message: JsonObject,
   method: string | null,
diff --git a/tests/codex/app-server-client.test.ts b/tests/codex/app-server-client.test.ts
index ea0485a..7cc7928 100644
--- a/tests/codex/app-server-client.test.ts
+++ b/tests/codex/app-server-client.test.ts
@@ -170,6 +170,41 @@ describe("CodexAppServerClient", () => {
     await client.close();
   });
 
+  it("accepts MCP tool approval elicitation with the expected payload", async () => {
+    const workspace = await createWorkspace();
+    const events: CodexClientEvent[] = [];
+    const client = createClient("mcp-elicitation", workspace, events);
+
+    const result = await client.startSession({
+      prompt: "Handle MCP elicitation",
+      title: "ABC-123: Example",
+    });
+
+    expect(result).toMatchObject({
+      status: "completed",
+      message: "MCP elicitation handled",
+      usage: {
+        inputTokens: 15,
+        outputTokens: 10,
+        totalTokens: 25,
+      },
+      rateLimits: {
+        requestsRemaining: 10,
+        tokensRemaining: 1000,
+      },
+    });
+    expect(events).toContainEqual(
+      expect.objectContaining({
+        event: "approval_auto_approved",
+        raw: expect.objectContaining({
+          method: "mcpServer/elicitation/request",
+        }),
+      }),
+    );
+
+    await client.close();
+  });
+
   it("fails the turn when user-input-required is emitted through a compatible variant", async () => {
     const workspace = await createWorkspace();
     const events: CodexClientEvent[] = [];
diff --git a/tests/fixtures/codex-fake-server.mjs b/tests/fixtures/codex-fake-server.mjs
index dbe7262..e6b5f81 100644
--- a/tests/fixtures/codex-fake-server.mjs
+++ b/tests/fixtures/codex-fake-server.mjs
@@ -137,6 +137,24 @@ async function handleMessage(message) {
       return;
     }
 
+    if (scenario === "mcp-elicitation") {
+      setTimeout(() => {
+        writeJson({
+          id: "elicitation-1",
+          method: "mcpServer/elicitation/request",
+          params: {
+            serverName: "linear",
+            _meta: {
+              codex_approval_kind: "mcp_tool_call",
+              persist: ["session", "always"],
+            },
+            message: 'Allow the linear MCP server to run tool "save_comment"?',
+          },
+        });
+      }, 10);
+      return;
+    }
+
     if (scenario === "user-input") {
       setTimeout(() => {
         writeJson({
@@ -262,6 +280,43 @@ async function handleMessage(message) {
     return;
   }
 
+  if (message.id === "elicitation-1") {
+    assertEqual(
+      message.result?.action,
+      "accept",
+      "MCP elicitation must be accepted with action=accept",
+    );
+    assertEqual(
+      typeof message.result?.content,
+      "object",
+      "MCP elicitation acceptance must include content object",
+    );
+    assertEqual(
+      message.result?._meta?.persist,
+      "always",
+      "MCP elicitation must prefer persist=always when present",
+    );
+
+    setTimeout(() => {
+      writeJson({
+        method: "turn/completed",
+        params: {
+          message: "MCP elicitation handled",
+          usage: {
+            inputTokens: 15,
+            outputTokens: 10,
+            totalTokens: 25,
+          },
+          rateLimits: {
+            requestsRemaining: 10,
+            tokensRemaining: 1000,
+          },
+        },
+      });
+    }, 10);
+    return;
+  }
+
   if (message.id === "tool-1") {
     if (scenario === "linear-tool") {
       assertEqual(