diff --git a/backend/app/tasks/rerender_accessible_video.py b/backend/app/tasks/rerender_accessible_video.py
index 268e0d4..bc03770 100644
--- a/backend/app/tasks/rerender_accessible_video.py
+++ b/backend/app/tasks/rerender_accessible_video.py
@@ -198,6 +198,17 @@ async def _async_rerender_accessible_video(
 
             logger.info(f"Downloaded {len(ad_segments)} AD cue segments")
 
+            # Validate VTT cue count matches MP3 count
+            vtt_cues = VTTParser.parse(ad_vtt_content)
+            downloaded_indices = set(idx for idx, _ in ad_segments)
+            if len(vtt_cues) != len(ad_segments):
+                missing_indices = set(range(len(vtt_cues))) - downloaded_indices
+                logger.warning(
+                    f"VTT cue count ({len(vtt_cues)}) does not match MP3 count ({len(ad_segments)}). "
+                    f"Missing MP3s for cue indices: {sorted(missing_indices)}. "
+                    f"This may happen when a new AD cue is inserted but TTS wasn't regenerated for shifted cues."
+                )
+
             # 4. Build placements with adjusted pause points
             method = lang_output.get("accessible_video_method", "pause_insert")
             pause_points = edit_state.get("pause_points", [])
diff --git a/frontend/src/components/VttEditor/VttEditor.tsx b/frontend/src/components/VttEditor/VttEditor.tsx
index 7716fae..32f9d31 100644
--- a/frontend/src/components/VttEditor/VttEditor.tsx
+++ b/frontend/src/components/VttEditor/VttEditor.tsx
@@ -40,11 +40,12 @@ interface VttEditorProps {
   vttContent: string;
   onChange: (content: string) => void;
   onCueSave?: (cueIndex: number, vttContent: string) => Promise<void>;
+  onCueInserted?: (insertedIndex: number, totalCues: number) => void;
   title: string;
   readOnly?: boolean;
 }
 
-export function VttEditor({ vttContent, onChange, onCueSave, title, readOnly = false }: VttEditorProps) {
+export function VttEditor({ vttContent, onChange, onCueSave, onCueInserted, title, readOnly = false }: VttEditorProps) {
   const [cues, setCues] = useState<VTTCue[]>([]);
   const [errors, setErrors] = useState<string[]>([]);
   const [editingCue, setEditingCue] = useState<number | null>(null);
@@ -159,6 +160,8 @@ export function VttEditor({ vttContent, onChange, onCueSave, title, readOnly = f
     updatedCues.splice(insertIndex, 0, newCue);
 
     updateCuesLocal(updatedCues);
+    // Notify parent about insertion so it can queue TTS for shifted cues
+    onCueInserted?.(insertIndex, updatedCues.length);
     // Auto-enter edit mode for the new cue
     setEditingCue(insertIndex);
   };
diff --git a/frontend/src/routes/admin/QCDetail.tsx b/frontend/src/routes/admin/QCDetail.tsx
index cd06b9c..2ade5f7 100644
--- a/frontend/src/routes/admin/QCDetail.tsx
+++ b/frontend/src/routes/admin/QCDetail.tsx
@@ -42,6 +42,12 @@ export function QCDetail() {
   const [pendingRegenerations, setPendingRegenerations] = useState<number[]>([]);
   const [pausePointsModified, setPausePointsModified] = useState(false);
 
+  // Track AD cue insertions to queue TTS for shifted cues
+  const [lastInsertedAdCue, setLastInsertedAdCue] = useState<{
+    insertIndex: number;
+    totalCues: number;
+  } | null>(null);
+
 
   // Fetch VTT content for selected language
   const { data: vttContent, isLoading: vttLoading } = useJobVttContent(id!, selectedLanguage);
@@ -97,6 +103,7 @@ export function QCDetail() {
   useEffect(() => {
     setPendingRegenerations([]);
     setPausePointsModified(false);
+    setLastInsertedAdCue(null);
   }, [selectedLanguage]);
 
   // Sync pending regenerations from server edit state
@@ -226,22 +233,51 @@ export function QCDetail() {
       }
     });
 
-    // Queue TTS regeneration for this cue
+    // Determine which cues need TTS regeneration
+    let cueIndicesToRegenerate: number[];
+
+    if (lastInsertedAdCue && cueIndex === lastInsertedAdCue.insertIndex) {
+      // This is the newly inserted cue being saved
+      // Queue TTS for this cue AND all shifted cues (from insertIndex to end)
+      cueIndicesToRegenerate = Array.from(
+        { length: lastInsertedAdCue.totalCues - lastInsertedAdCue.insertIndex },
+        (_, i) => lastInsertedAdCue.insertIndex + i
+      );
+      setLastInsertedAdCue(null);  // Clear insertion context
+    } else {
+      // Normal edit, just this cue
+      cueIndicesToRegenerate = [cueIndex];
+    }
+
+    // Queue TTS regeneration for the cues
     try {
       await queueTTSRegenerationMutation.mutateAsync({
         jobId: id,
         language: selectedLanguage,
-        cueIndices: [cueIndex],
+        cueIndices: cueIndicesToRegenerate,
       });
       // Update local pending regenerations
-      setPendingRegenerations(prev => [...new Set([...prev, cueIndex])]);
-      toast.toastOnly.success(`AD cue ${cueIndex + 1} saved and queued for TTS`);
+      setPendingRegenerations(prev => [...new Set([...prev, ...cueIndicesToRegenerate])]);
+
+      const cueCount = cueIndicesToRegenerate.length;
+      if (cueCount > 1) {
+        toast.toastOnly.success(
+          `AD cue inserted. Queued TTS for ${cueCount} cues (indices ${cueIndicesToRegenerate.join(', ')})`
+        );
+      } else {
+        toast.toastOnly.success(`AD cue ${cueIndex + 1} saved and queued for TTS`);
+      }
     } catch (queueError) {
       console.error('Failed to queue TTS regeneration:', queueError);
       toast.toastOnly.success(`AD cue ${cueIndex + 1} saved (TTS queue failed - queue manually)`);
     }
   };
 
+  // Handler for AD cue insertions - tracks context for TTS queueing
+  const handleAdCueInserted = (insertedIndex: number, totalCues: number) => {
+    setLastInsertedAdCue({ insertIndex: insertedIndex, totalCues });
+  };
+
   const handleApprove = async () => {
     if (!id) return;
 
@@ -695,6 +731,7 @@ export function QCDetail() {
               vttContent={adVtt}
               onChange={handleAdChange}
               onCueSave={handleAdCueSave}
+              onCueInserted={handleAdCueInserted}
               title={`Audio Description (${selectedLanguage.toUpperCase()})`}
               readOnly={isProcessing}
             />