Concepts and technologies disclosed herein are directed to need-based generation of multi-modal communication aids to aid verbal communications. According to one aspect disclosed herein, a user system can receive a request for a multi-modal communication aid to be used during a communications session between the user system and an additional user system. The communications session can include live audio and/or live video. The request can be received in response to a technology issue (e.g., poor audio quality) and/or a user issue (e.g., difficulty hearing). In response to the request, the user system can receive a selection of the multi-modal communication aid. The selection can be based upon a pre-defined multi-modal communication aid or a newly-created multi-modal communication aid (e.g., user-created or artificial intelligence-created). The user system can the provide the multi-modal communication aid to the additional user system via the communications service.