diff --git a/homeassistant/components/recorder/const.py b/homeassistant/components/recorder/const.py
index 5b623ee5e04..5d650ec83e2 100644
--- a/homeassistant/components/recorder/const.py
+++ b/homeassistant/components/recorder/const.py
@@ -4,6 +4,7 @@ from functools import partial
 import json
 from typing import Final
 
+from homeassistant.backports.enum import StrEnum
 from homeassistant.const import ATTR_ATTRIBUTION, ATTR_RESTORED, ATTR_SUPPORTED_FEATURES
 from homeassistant.helpers.json import JSONEncoder
 
@@ -37,3 +38,11 @@ KEEPALIVE_TIME = 30
 
 
 EXCLUDE_ATTRIBUTES = f"{DOMAIN}_exclude_attributes_by_domain"
+
+
+class SupportedDialect(StrEnum):
+    """Supported dialects."""
+
+    SQLITE = "sqlite"
+    MYSQL = "mysql"
+    POSTGRESQL = "postgresql"
diff --git a/homeassistant/components/recorder/core.py b/homeassistant/components/recorder/core.py
index 49be0aac705..a008ae6767b 100644
--- a/homeassistant/components/recorder/core.py
+++ b/homeassistant/components/recorder/core.py
@@ -3,6 +3,7 @@ from __future__ import annotations
 
 import asyncio
 from collections.abc import Callable, Iterable
+import contextlib
 from datetime import datetime, timedelta
 import logging
 import queue
@@ -41,6 +42,7 @@ from .const import (
     KEEPALIVE_TIME,
     MAX_QUEUE_BACKLOG,
     SQLITE_URL_PREFIX,
+    SupportedDialect,
 )
 from .executor import DBInterruptibleThreadPoolExecutor
 from .models import (
@@ -193,6 +195,13 @@ class Recorder(threading.Thread):
         """Return the number of items in the recorder backlog."""
         return self._queue.qsize()
 
+    @property
+    def dialect_name(self) -> SupportedDialect | None:
+        """Return the dialect the recorder uses."""
+        with contextlib.suppress(ValueError):
+            return SupportedDialect(self.engine.dialect.name) if self.engine else None
+        return None
+
     @property
     def _using_file_sqlite(self) -> bool:
         """Short version to check if we are using sqlite3 as a file."""
@@ -459,11 +468,6 @@ class Recorder(threading.Thread):
         """Schedule external statistics."""
         self.queue_task(ExternalStatisticsTask(metadata, stats))
 
-    @callback
-    def using_sqlite(self) -> bool:
-        """Return if recorder uses sqlite as the engine."""
-        return bool(self.engine and self.engine.dialect.name == "sqlite")
-
     @callback
     def _async_setup_periodic_tasks(self) -> None:
         """Prepare periodic tasks."""
@@ -473,7 +477,7 @@ class Recorder(threading.Thread):
 
         # If the db is using a socket connection, we need to keep alive
         # to prevent errors from unexpected disconnects
-        if not self.using_sqlite():
+        if self.dialect_name != SupportedDialect.SQLITE:
             self._keep_alive_listener = async_track_time_interval(
                 self.hass, self._async_keep_alive, timedelta(seconds=KEEPALIVE_TIME)
             )
@@ -939,7 +943,7 @@ class Recorder(threading.Thread):
 
     async def lock_database(self) -> bool:
         """Lock database so it can be backed up safely."""
-        if not self.using_sqlite():
+        if self.dialect_name != SupportedDialect.SQLITE:
             _LOGGER.debug(
                 "Not a SQLite database or not connected, locking not necessary"
             )
@@ -968,7 +972,7 @@ class Recorder(threading.Thread):
 
         Returns true if database lock has been held throughout the process.
         """
-        if not self.using_sqlite():
+        if self.dialect_name != SupportedDialect.SQLITE:
             _LOGGER.debug(
                 "Not a SQLite database or not connected, unlocking not necessary"
             )
diff --git a/homeassistant/components/recorder/migration.py b/homeassistant/components/recorder/migration.py
index b38bb89b5b9..5da31f18781 100644
--- a/homeassistant/components/recorder/migration.py
+++ b/homeassistant/components/recorder/migration.py
@@ -21,6 +21,7 @@ from sqlalchemy.sql.expression import true
 
 from homeassistant.core import HomeAssistant
 
+from .const import SupportedDialect
 from .models import (
     SCHEMA_VERSION,
     TABLE_STATES,
@@ -263,7 +264,7 @@ def _modify_columns(
     columns_def: list[str],
 ) -> None:
     """Modify columns in a table."""
-    if engine.dialect.name == "sqlite":
+    if engine.dialect.name == SupportedDialect.SQLITE:
         _LOGGER.debug(
             "Skipping to modify columns %s in table %s; "
             "Modifying column length in SQLite is unnecessary, "
@@ -281,7 +282,7 @@ def _modify_columns(
         table_name,
     )
 
-    if engine.dialect.name == "postgresql":
+    if engine.dialect.name == SupportedDialect.POSTGRESQL:
         columns_def = [
             "ALTER {column} TYPE {type}".format(
                 **dict(zip(["column", "type"], col_def.split(" ", 1)))
@@ -408,7 +409,7 @@ def _apply_update(  # noqa: C901
 ) -> None:
     """Perform operations to bring schema up to date."""
     dialect = engine.dialect.name
-    big_int = "INTEGER(20)" if dialect == "mysql" else "INTEGER"
+    big_int = "INTEGER(20)" if dialect == SupportedDialect.MYSQL else "INTEGER"
 
     if new_version == 1:
         _create_index(session_maker, "events", "ix_events_time_fired")
@@ -487,11 +488,11 @@ def _apply_update(  # noqa: C901
         _create_index(session_maker, "states", "ix_states_old_state_id")
         _update_states_table_with_foreign_key_options(session_maker, engine)
     elif new_version == 12:
-        if engine.dialect.name == "mysql":
+        if engine.dialect.name == SupportedDialect.MYSQL:
             _modify_columns(session_maker, engine, "events", ["event_data LONGTEXT"])
             _modify_columns(session_maker, engine, "states", ["attributes LONGTEXT"])
     elif new_version == 13:
-        if engine.dialect.name == "mysql":
+        if engine.dialect.name == SupportedDialect.MYSQL:
             _modify_columns(
                 session_maker,
                 engine,
@@ -545,7 +546,7 @@ def _apply_update(  # noqa: C901
             session.add(StatisticsRuns(start=get_start_time()))
     elif new_version == 20:
         # This changed the precision of statistics from float to double
-        if engine.dialect.name in ["mysql", "postgresql"]:
+        if engine.dialect.name in [SupportedDialect.MYSQL, SupportedDialect.POSTGRESQL]:
             _modify_columns(
                 session_maker,
                 engine,
@@ -560,7 +561,7 @@ def _apply_update(  # noqa: C901
             )
     elif new_version == 21:
         # Try to change the character set of the statistic_meta table
-        if engine.dialect.name == "mysql":
+        if engine.dialect.name == SupportedDialect.MYSQL:
             for table in ("events", "states", "statistics_meta"):
                 _LOGGER.warning(
                     "Updating character set and collation of table %s to utf8mb4. "
diff --git a/homeassistant/components/recorder/purge.py b/homeassistant/components/recorder/purge.py
index b2547d13e45..2c6211ca2cd 100644
--- a/homeassistant/components/recorder/purge.py
+++ b/homeassistant/components/recorder/purge.py
@@ -13,7 +13,7 @@ from sqlalchemy.sql.expression import distinct
 
 from homeassistant.const import EVENT_STATE_CHANGED
 
-from .const import MAX_ROWS_TO_PURGE
+from .const import MAX_ROWS_TO_PURGE, SupportedDialect
 from .models import (
     EventData,
     Events,
@@ -45,7 +45,7 @@ def purge_old_data(
         "Purging states and events before target %s",
         purge_before.isoformat(sep=" ", timespec="seconds"),
     )
-    using_sqlite = instance.using_sqlite()
+    using_sqlite = instance.dialect_name == SupportedDialect.SQLITE
 
     with session_scope(session=instance.get_session()) as session:
         # Purge a max of MAX_ROWS_TO_PURGE, based on the oldest states or events record
@@ -425,7 +425,7 @@ def _purge_old_recorder_runs(
 def _purge_filtered_data(instance: Recorder, session: Session) -> bool:
     """Remove filtered states and events that shouldn't be in the database."""
     _LOGGER.debug("Cleanup filtered data")
-    using_sqlite = instance.using_sqlite()
+    using_sqlite = instance.dialect_name == SupportedDialect.SQLITE
 
     # Check if excluded entity_ids are in database
     excluded_entity_ids: list[str] = [
@@ -484,7 +484,7 @@ def _purge_filtered_events(
     instance: Recorder, session: Session, excluded_event_types: list[str]
 ) -> None:
     """Remove filtered events and linked states."""
-    using_sqlite = instance.using_sqlite()
+    using_sqlite = instance.dialect_name == SupportedDialect.SQLITE
     event_ids, data_ids = zip(
         *(
             session.query(Events.event_id, Events.data_id)
@@ -514,7 +514,7 @@ def _purge_filtered_events(
 @retryable_database_job("purge")
 def purge_entity_data(instance: Recorder, entity_filter: Callable[[str], bool]) -> bool:
     """Purge states and events of specified entities."""
-    using_sqlite = instance.using_sqlite()
+    using_sqlite = instance.dialect_name == SupportedDialect.SQLITE
     with session_scope(session=instance.get_session()) as session:
         selected_entity_ids: list[str] = [
             entity_id
diff --git a/homeassistant/components/recorder/repack.py b/homeassistant/components/recorder/repack.py
index c272f2827a0..c05b8390724 100644
--- a/homeassistant/components/recorder/repack.py
+++ b/homeassistant/components/recorder/repack.py
@@ -6,6 +6,8 @@ from typing import TYPE_CHECKING
 
 from sqlalchemy import text
 
+from .const import SupportedDialect
+
 if TYPE_CHECKING:
     from . import Recorder
 
@@ -18,7 +20,7 @@ def repack_database(instance: Recorder) -> None:
     dialect_name = instance.engine.dialect.name
 
     # Execute sqlite command to free up space on disk
-    if dialect_name == "sqlite":
+    if dialect_name == SupportedDialect.SQLITE:
         _LOGGER.debug("Vacuuming SQL DB to free space")
         with instance.engine.connect() as conn:
             conn.execute(text("VACUUM"))
@@ -26,7 +28,7 @@ def repack_database(instance: Recorder) -> None:
         return
 
     # Execute postgresql vacuum command to free up space on disk
-    if dialect_name == "postgresql":
+    if dialect_name == SupportedDialect.POSTGRESQL:
         _LOGGER.debug("Vacuuming SQL DB to free space")
         with instance.engine.connect().execution_options(
             isolation_level="AUTOCOMMIT"
@@ -36,7 +38,7 @@ def repack_database(instance: Recorder) -> None:
         return
 
     # Optimize mysql / mariadb tables to free up space on disk
-    if dialect_name == "mysql":
+    if dialect_name == SupportedDialect.MYSQL:
         _LOGGER.debug("Optimizing SQL DB to free space")
         with instance.engine.connect() as conn:
             conn.execute(text("OPTIMIZE TABLE states, events, recorder_runs"))
diff --git a/homeassistant/components/recorder/statistics.py b/homeassistant/components/recorder/statistics.py
index 9104fb7e234..d8ba415cc7a 100644
--- a/homeassistant/components/recorder/statistics.py
+++ b/homeassistant/components/recorder/statistics.py
@@ -38,7 +38,7 @@ import homeassistant.util.temperature as temperature_util
 from homeassistant.util.unit_system import UnitSystem
 import homeassistant.util.volume as volume_util
 
-from .const import DATA_INSTANCE, DOMAIN, MAX_ROWS_TO_PURGE
+from .const import DATA_INSTANCE, DOMAIN, MAX_ROWS_TO_PURGE, SupportedDialect
 from .models import (
     StatisticData,
     StatisticMetaData,
@@ -1342,10 +1342,13 @@ def _filter_unique_constraint_integrity_error(
         dialect_name = instance.engine.dialect.name
 
         ignore = False
-        if dialect_name == "sqlite" and "UNIQUE constraint failed" in str(err):
+        if (
+            dialect_name == SupportedDialect.SQLITE
+            and "UNIQUE constraint failed" in str(err)
+        ):
             ignore = True
         if (
-            dialect_name == "postgresql"
+            dialect_name == SupportedDialect.POSTGRESQL
             and hasattr(err.orig, "pgcode")
             and err.orig.pgcode == "23505"
         ):
diff --git a/homeassistant/components/recorder/strings.json b/homeassistant/components/recorder/strings.json
index 72fcf322c31..b475b29a16a 100644
--- a/homeassistant/components/recorder/strings.json
+++ b/homeassistant/components/recorder/strings.json
@@ -2,7 +2,8 @@
   "system_health": {
     "info": {
       "oldest_recorder_run": "Oldest Run Start Time",
-      "current_recorder_run": "Current Run Start Time"
+      "current_recorder_run": "Current Run Start Time",
+      "estimated_db_size": "Estimated Database Size (MiB)"
     }
   }
 }
diff --git a/homeassistant/components/recorder/system_health.py b/homeassistant/components/recorder/system_health.py
deleted file mode 100644
index 2a9c536a2d6..00000000000
--- a/homeassistant/components/recorder/system_health.py
+++ /dev/null
@@ -1,26 +0,0 @@
-"""Provide info to system health."""
-
-from typing import Any
-
-from homeassistant.components import system_health
-from homeassistant.core import HomeAssistant, callback
-
-from . import get_instance
-
-
-@callback
-def async_register(
-    hass: HomeAssistant, register: system_health.SystemHealthRegistration
-) -> None:
-    """Register system health callbacks."""
-    register.async_register_info(system_health_info)
-
-
-async def system_health_info(hass: HomeAssistant) -> dict[str, Any]:
-    """Get info for the info page."""
-    instance = get_instance(hass)
-    run_history = instance.run_history
-    return {
-        "oldest_recorder_run": run_history.first.start,
-        "current_recorder_run": run_history.current.start,
-    }
diff --git a/homeassistant/components/recorder/system_health/__init__.py b/homeassistant/components/recorder/system_health/__init__.py
new file mode 100644
index 00000000000..3250aecf356
--- /dev/null
+++ b/homeassistant/components/recorder/system_health/__init__.py
@@ -0,0 +1,60 @@
+"""Provide info to system health."""
+from __future__ import annotations
+
+from typing import Any
+
+from yarl import URL
+
+from homeassistant.components import system_health
+from homeassistant.components.recorder.core import Recorder
+from homeassistant.components.recorder.util import session_scope
+from homeassistant.core import HomeAssistant, callback
+
+from .. import get_instance
+from ..const import SupportedDialect
+from .mysql import db_size_bytes as mysql_db_size_bytes
+from .postgresql import db_size_bytes as postgresql_db_size_bytes
+from .sqlite import db_size_bytes as sqlite_db_size_bytes
+
+DIALECT_TO_GET_SIZE = {
+    SupportedDialect.SQLITE: sqlite_db_size_bytes,
+    SupportedDialect.MYSQL: mysql_db_size_bytes,
+    SupportedDialect.POSTGRESQL: postgresql_db_size_bytes,
+}
+
+
+@callback
+def async_register(
+    hass: HomeAssistant, register: system_health.SystemHealthRegistration
+) -> None:
+    """Register system health callbacks."""
+    register.async_register_info(system_health_info)
+
+
+def _get_db_stats(instance: Recorder, database_name: str) -> dict[str, Any]:
+    """Get the stats about the database."""
+    db_stats: dict[str, Any] = {}
+    with session_scope(session=instance.get_session()) as session:
+        if (
+            (dialect_name := instance.dialect_name)
+            and (get_size := DIALECT_TO_GET_SIZE.get(dialect_name))
+            and (db_bytes := get_size(session, database_name))
+        ):
+            db_stats["estimated_db_size"] = f"{db_bytes/1024/1024:.2f} MiB"
+    return db_stats
+
+
+async def system_health_info(hass: HomeAssistant) -> dict[str, Any]:
+    """Get info for the info page."""
+    instance = get_instance(hass)
+    run_history = instance.run_history
+    database_name = URL(instance.db_url).path.lstrip("/")
+    db_stats: dict[str, Any] = {}
+    if instance.async_db_ready.done():
+        db_stats = await instance.async_add_executor_job(
+            _get_db_stats, instance, database_name
+        )
+    return {
+        "oldest_recorder_run": run_history.first.start,
+        "current_recorder_run": run_history.current.start,
+    } | db_stats
diff --git a/homeassistant/components/recorder/system_health/mysql.py b/homeassistant/components/recorder/system_health/mysql.py
new file mode 100644
index 00000000000..52ea06f61c3
--- /dev/null
+++ b/homeassistant/components/recorder/system_health/mysql.py
@@ -0,0 +1,19 @@
+"""Provide info to system health for mysql."""
+from __future__ import annotations
+
+from sqlalchemy import text
+from sqlalchemy.orm.session import Session
+
+
+def db_size_bytes(session: Session, database_name: str) -> float:
+    """Get the mysql database size."""
+    return float(
+        session.execute(
+            text(
+                "SELECT ROUND(SUM(DATA_LENGTH + INDEX_LENGTH), 2) "
+                "FROM information_schema.TABLES WHERE "
+                "TABLE_SCHEMA=:database_name"
+            ),
+            {"database_name": database_name},
+        ).first()[0]
+    )
diff --git a/homeassistant/components/recorder/system_health/postgresql.py b/homeassistant/components/recorder/system_health/postgresql.py
new file mode 100644
index 00000000000..3e0667b1f4f
--- /dev/null
+++ b/homeassistant/components/recorder/system_health/postgresql.py
@@ -0,0 +1,15 @@
+"""Provide info to system health for postgresql."""
+from __future__ import annotations
+
+from sqlalchemy import text
+from sqlalchemy.orm.session import Session
+
+
+def db_size_bytes(session: Session, database_name: str) -> float:
+    """Get the mysql database size."""
+    return float(
+        session.execute(
+            text("select pg_database_size(:database_name);"),
+            {"database_name": database_name},
+        ).first()[0]
+    )
diff --git a/homeassistant/components/recorder/system_health/sqlite.py b/homeassistant/components/recorder/system_health/sqlite.py
new file mode 100644
index 00000000000..5a5901d2cb3
--- /dev/null
+++ b/homeassistant/components/recorder/system_health/sqlite.py
@@ -0,0 +1,17 @@
+"""Provide info to system health for sqlite."""
+from __future__ import annotations
+
+from sqlalchemy import text
+from sqlalchemy.orm.session import Session
+
+
+def db_size_bytes(session: Session, database_name: str) -> float:
+    """Get the mysql database size."""
+    return float(
+        session.execute(
+            text(
+                "SELECT page_count * page_size as size "
+                "FROM pragma_page_count(), pragma_page_size();"
+            )
+        ).first()[0]
+    )
diff --git a/homeassistant/components/recorder/translations/en.json b/homeassistant/components/recorder/translations/en.json
index a44ecd3c1d6..32d78085999 100644
--- a/homeassistant/components/recorder/translations/en.json
+++ b/homeassistant/components/recorder/translations/en.json
@@ -2,7 +2,8 @@
     "system_health": {
         "info": {
             "current_recorder_run": "Current Run Start Time",
-            "oldest_recorder_run": "Oldest Run Start Time"
+            "oldest_recorder_run": "Oldest Run Start Time",
+            "estimated_db_size": "Estimated Database Size"
         }
     }
 }
\ No newline at end of file
diff --git a/homeassistant/components/recorder/util.py b/homeassistant/components/recorder/util.py
index b63bbe740bc..3d9fa7d29e1 100644
--- a/homeassistant/components/recorder/util.py
+++ b/homeassistant/components/recorder/util.py
@@ -25,7 +25,7 @@ from typing_extensions import Concatenate, ParamSpec
 from homeassistant.core import HomeAssistant
 import homeassistant.util.dt as dt_util
 
-from .const import DATA_INSTANCE, SQLITE_URL_PREFIX
+from .const import DATA_INSTANCE, SQLITE_URL_PREFIX, SupportedDialect
 from .models import (
     ALL_TABLES,
     TABLE_RECORDER_RUNS,
@@ -353,7 +353,7 @@ def setup_connection_for_dialect(
     # Returns False if the the connection needs to be setup
     # on the next connection, returns True if the connection
     # never needs to be setup again.
-    if dialect_name == "sqlite":
+    if dialect_name == SupportedDialect.SQLITE:
         if first_connection:
             old_isolation = dbapi_connection.isolation_level
             dbapi_connection.isolation_level = None
@@ -381,7 +381,7 @@ def setup_connection_for_dialect(
         # enable support for foreign keys
         execute_on_connection(dbapi_connection, "PRAGMA foreign_keys=ON")
 
-    elif dialect_name == "mysql":
+    elif dialect_name == SupportedDialect.MYSQL:
         execute_on_connection(dbapi_connection, "SET session wait_timeout=28800")
         if first_connection:
             result = query_on_connection(dbapi_connection, "SELECT VERSION()")
@@ -408,7 +408,7 @@ def setup_connection_for_dialect(
                         version or version_string, "MySQL", MIN_VERSION_MYSQL
                     )
 
-    elif dialect_name == "postgresql":
+    elif dialect_name == SupportedDialect.POSTGRESQL:
         if first_connection:
             # server_version_num was added in 2006
             result = query_on_connection(dbapi_connection, "SHOW server_version")
@@ -455,7 +455,7 @@ def retryable_database_job(
             except OperationalError as err:
                 assert instance.engine is not None
                 if (
-                    instance.engine.dialect.name == "mysql"
+                    instance.engine.dialect.name == SupportedDialect.MYSQL
                     and err.orig.args[0] in RETRYABLE_MYSQL_ERRORS
                 ):
                     _LOGGER.info(
@@ -481,7 +481,7 @@ def periodic_db_cleanups(instance: Recorder) -> None:
     These cleanups will happen nightly or after any purge.
     """
     assert instance.engine is not None
-    if instance.engine.dialect.name == "sqlite":
+    if instance.engine.dialect.name == SupportedDialect.SQLITE:
         # Execute sqlite to create a wal checkpoint and free up disk space
         _LOGGER.debug("WAL checkpoint")
         with instance.engine.connect() as connection:
diff --git a/tests/components/recorder/test_init.py b/tests/components/recorder/test_init.py
index 17287151bc1..0b2b7b2dcb8 100644
--- a/tests/components/recorder/test_init.py
+++ b/tests/components/recorder/test_init.py
@@ -1440,9 +1440,7 @@ async def test_database_connection_keep_alive(
     caplog: pytest.LogCaptureFixture,
 ):
     """Test we keep alive socket based dialects."""
-    with patch(
-        "homeassistant.components.recorder.Recorder.using_sqlite", return_value=False
-    ):
+    with patch("homeassistant.components.recorder.Recorder.dialect_name"):
         instance = await async_setup_recorder_instance(hass)
         # We have to mock this since we don't have a mock
         # MySQL server available in tests.
diff --git a/tests/components/recorder/test_purge.py b/tests/components/recorder/test_purge.py
index 2d711f17cf3..de9db9d5014 100644
--- a/tests/components/recorder/test_purge.py
+++ b/tests/components/recorder/test_purge.py
@@ -9,7 +9,7 @@ from sqlalchemy.exc import DatabaseError, OperationalError
 from sqlalchemy.orm.session import Session
 
 from homeassistant.components import recorder
-from homeassistant.components.recorder.const import MAX_ROWS_TO_PURGE
+from homeassistant.components.recorder.const import MAX_ROWS_TO_PURGE, SupportedDialect
 from homeassistant.components.recorder.models import (
     Events,
     RecorderRuns,
@@ -43,8 +43,10 @@ from tests.common import SetupRecorderInstanceT
 def mock_use_sqlite(request):
     """Pytest fixture to switch purge method."""
     with patch(
-        "homeassistant.components.recorder.Recorder.using_sqlite",
-        return_value=request.param,
+        "homeassistant.components.recorder.core.Recorder.dialect_name",
+        return_value=SupportedDialect.SQLITE
+        if request.param
+        else SupportedDialect.MYSQL,
     ):
         yield
 
diff --git a/tests/components/recorder/test_system_health.py b/tests/components/recorder/test_system_health.py
index 75abc2b6ae1..8a8d9ea4e80 100644
--- a/tests/components/recorder/test_system_health.py
+++ b/tests/components/recorder/test_system_health.py
@@ -1,8 +1,11 @@
 """Test recorder system health."""
 
-from unittest.mock import patch
+from unittest.mock import ANY, Mock, patch
+
+import pytest
 
 from homeassistant.components.recorder import get_instance
+from homeassistant.components.recorder.const import SupportedDialect
 from homeassistant.core import HomeAssistant
 from homeassistant.setup import async_setup_component
 
@@ -20,6 +23,29 @@ async def test_recorder_system_health(hass, recorder_mock):
     assert info == {
         "current_recorder_run": instance.run_history.current.start,
         "oldest_recorder_run": instance.run_history.first.start,
+        "estimated_db_size": ANY,
+    }
+
+
+@pytest.mark.parametrize(
+    "dialect_name", [SupportedDialect.MYSQL, SupportedDialect.POSTGRESQL]
+)
+async def test_recorder_system_health_alternate_dbms(hass, recorder_mock, dialect_name):
+    """Test recorder system health."""
+    assert await async_setup_component(hass, "system_health", {})
+    await async_wait_recording_done(hass)
+    with patch(
+        "homeassistant.components.recorder.core.Recorder.dialect_name", dialect_name
+    ), patch(
+        "sqlalchemy.orm.session.Session.execute",
+        return_value=Mock(first=Mock(return_value=("1048576",))),
+    ):
+        info = await get_system_health_info(hass, "recorder")
+    instance = get_instance(hass)
+    assert info == {
+        "current_recorder_run": instance.run_history.current.start,
+        "oldest_recorder_run": instance.run_history.first.start,
+        "estimated_db_size": "1.00 MiB",
     }
 
 
@@ -35,4 +61,5 @@ async def test_recorder_system_health_crashed_recorder_runs_table(
     assert info == {
         "current_recorder_run": instance.run_history.current.start,
         "oldest_recorder_run": instance.run_history.current.start,
+        "estimated_db_size": ANY,
     }