diff --git a/public/components/assistant.html b/public/components/assistant.html
index 2a54a469..e99bdaff 100644
--- a/public/components/assistant.html
+++ b/public/components/assistant.html
@@ -91,6 +91,14 @@
                         <button id="btn-assistant-takehome" class="assistant-plus-item" type="button" role="menuitem"><i class="fas fa-heart"></i> Patient take home</button>
                         <button id="btn-assistant-export-pdf" class="assistant-plus-item" type="button" role="menuitem"><i class="fas fa-file-pdf"></i> Export PDF</button>
                         <button id="btn-assistant-download-chat" class="assistant-plus-item" type="button" role="menuitem"><i class="fas fa-download"></i> Download transcript</button>
+                        <!-- A keyboard preference belongs to the keyboard, so it
+                             lives beside the composer rather than in Settings,
+                             and is remembered per device: Enter-to-send suits a
+                             desk and often does not suit a phone. -->
+                        <label class="assistant-plus-item" role="menuitemcheckbox" style="cursor:pointer;">
+                          <input type="checkbox" id="assistant-enter-sends" style="margin-right:8px;">
+                          Enter sends the message
+                        </label>
                       </div>
                     </div>
                     <input type="file" id="assistant-attach-input" accept="image/png,image/jpeg,image/webp" multiple hidden>
diff --git a/public/js/clinicalAssistant.js b/public/js/clinicalAssistant.js
index 1db5b848..fbf454af 100644
--- a/public/js/clinicalAssistant.js
+++ b/public/js/clinicalAssistant.js
@@ -137,6 +137,35 @@ import {
     document.addEventListener(type, handler);
   }
 
+  // Per device, not per account: a keyboard preference belongs to the keyboard.
+  // Someone who wants Enter to send at a desk usually does not want it on a
+  // phone, where Enter is how you get a second line in a note.
+  var ENTER_KEY = 'ped_assistant_enter_sends';
+
+  function enterSends() {
+    try {
+      var saved = localStorage.getItem(ENTER_KEY);
+      if (saved === '1') return true;
+      if (saved === '0') return false;
+    } catch (e) { /* private window, blocked storage: fall through to the default */ }
+    // Unset: send on a device with a real keyboard, newline on a touch one.
+    try { return !window.matchMedia('(hover: none) and (pointer: coarse)').matches; }
+    catch (e) { return true; }
+  }
+
+  function setEnterSends(on) {
+    try { localStorage.setItem(ENTER_KEY, on ? '1' : '0'); } catch (e) {}
+  }
+
+  // Say which key sends, where someone is already looking when they wonder.
+  function applyEnterHint() {
+    var input = document.getElementById('assistant-input');
+    if (!input) return;
+    input.title = enterSends()
+      ? 'Enter sends · Shift+Enter for a new line'
+      : 'Enter for a new line · Ctrl+Enter sends';
+  }
+
   function bindEvents() {
     var form = document.getElementById('assistant-form');
     var clearBtn = document.getElementById('btn-assistant-clear');
@@ -319,10 +348,35 @@ import {
     if (attachInput) attachInput.addEventListener('change', onAttachFiles);
     document.addEventListener('click', onAssistantDocumentClick);
     document.addEventListener('keydown', onAssistantKeydown);
+    // Enter: send, or newline. Two rules never change, whatever the preference —
+    // Shift+Enter is always a newline, and Ctrl/Cmd+Enter always sends. Those
+    // are the muscle memory people arrive with, and a setting that broke either
+    // would be worse than no setting.
+    //
+    // Composition matters: an IME (Chinese, Japanese, Korean, and predictive
+    // keyboards on Android) uses Enter to accept a candidate word. Sending on
+    // that would cut a sentence in half mid-word, so a keystroke during
+    // composition is never a send.
     if (input) input.addEventListener('keydown', function (e) {
-      if ((e.ctrlKey || e.metaKey) && e.key === 'Enter') onAsk(e);
+      if (e.key !== 'Enter') return;
+      if (e.isComposing || e.keyCode === 229) return;
+      if ((e.ctrlKey || e.metaKey)) { e.preventDefault(); onAsk(e); return; }
+      if (e.shiftKey || e.altKey) return;          // newline, always
+      if (!enterSends()) return;                   // newline, by preference
+      e.preventDefault();
+      onAsk(e);
     });
 
+    var enterToggle = document.getElementById('assistant-enter-sends');
+    if (enterToggle) {
+      enterToggle.checked = enterSends();
+      enterToggle.addEventListener('change', function () {
+        setEnterSends(enterToggle.checked);
+        applyEnterHint();
+      });
+    }
+    applyEnterHint();
+
     bindExampleButtons(document);
     loadSavedChats();
     documentListenersBound = true; // every delegated listener above is now registered
diff --git a/test/assistant-enter-to-send.test.js b/test/assistant-enter-to-send.test.js
new file mode 100644
index 00000000..9c86201d
--- /dev/null
+++ b/test/assistant-enter-to-send.test.js
@@ -0,0 +1,51 @@
+// Enter sends, or makes a newline, and the person decides. Two rules hold
+// whatever they choose: Shift+Enter is always a newline, Ctrl/Cmd+Enter always
+// sends. Those are the habits people arrive with.
+const test = require('node:test');
+const assert = require('node:assert/strict');
+const fs = require('node:fs');
+const path = require('node:path');
+
+const src = fs.readFileSync(path.join(__dirname, '..', 'public/js/clinicalAssistant.js'), 'utf8');
+const handler = src.slice(src.indexOf("input.addEventListener('keydown'"), src.indexOf('var enterToggle'));
+
+test('Ctrl or Cmd + Enter always sends, whatever the preference', () => {
+  assert.match(handler, /if \(\(e\.ctrlKey \|\| e\.metaKey\)\) \{ e\.preventDefault\(\); onAsk\(e\); return; \}/);
+  // It is checked before the preference, so it cannot be switched off.
+  assert.ok(handler.indexOf('ctrlKey') < handler.indexOf('enterSends()'),
+    'the modifier must win over the preference');
+});
+
+test('Shift+Enter is always a newline, whatever the preference', () => {
+  assert.match(handler, /if \(e\.shiftKey \|\| e\.altKey\) return;/);
+  assert.ok(handler.indexOf('shiftKey') < handler.indexOf('enterSends()'));
+});
+
+test('an IME composition keystroke never sends', () => {
+  // Enter accepts a candidate word in Chinese, Japanese, Korean and on
+  // predictive Android keyboards. Sending there cuts a sentence mid-word.
+  assert.match(handler, /if \(e\.isComposing \|\| e\.keyCode === 229\) return;/);
+  assert.ok(handler.indexOf('isComposing') < handler.indexOf('ctrlKey'),
+    'composition is checked before anything can send');
+});
+
+test('the preference is per device, and survives storage being unavailable', () => {
+  const pref = src.slice(src.indexOf('function enterSends()'), src.indexOf('function applyEnterHint'));
+  assert.match(pref, /localStorage\.getItem\(ENTER_KEY\)/);
+  assert.match(pref, /catch \(e\)/, 'a private window must not throw here');
+  // Unset defaults by device class rather than guessing one answer for both.
+  assert.match(pref, /\(hover: none\) and \(pointer: coarse\)/);
+});
+
+test('the toggle reflects and writes the preference', () => {
+  const bind = src.slice(src.indexOf('var enterToggle'), src.indexOf('bindExampleButtons'));
+  assert.match(bind, /enterToggle\.checked = enterSends\(\)/, 'opens showing the current state');
+  assert.match(bind, /setEnterSends\(enterToggle\.checked\)/);
+  const html = fs.readFileSync(path.join(__dirname, '..', 'public/components/assistant.html'), 'utf8');
+  assert.match(html, /id="assistant-enter-sends"/);
+});
+
+test('the composer says which key sends', () => {
+  assert.match(src, /Enter sends · Shift\+Enter for a new line/);
+  assert.match(src, /Enter for a new line · Ctrl\+Enter sends/);
+});