diff --git a/homeassistant/components/mastodon/notify.py b/homeassistant/components/mastodon/notify.py
index 97ab2145486..1ab47896b0d 100644
--- a/homeassistant/components/mastodon/notify.py
+++ b/homeassistant/components/mastodon/notify.py
@@ -2,13 +2,18 @@
 
 from __future__ import annotations
 
+import mimetypes
 from typing import Any
 
 from mastodon import Mastodon
 from mastodon.Mastodon import MastodonAPIError, MastodonUnauthorizedError
 import voluptuous as vol
 
-from homeassistant.components.notify import PLATFORM_SCHEMA, BaseNotificationService
+from homeassistant.components.notify import (
+    ATTR_DATA,
+    PLATFORM_SCHEMA,
+    BaseNotificationService,
+)
 from homeassistant.const import CONF_ACCESS_TOKEN, CONF_CLIENT_ID, CONF_CLIENT_SECRET
 from homeassistant.core import HomeAssistant
 from homeassistant.helpers import config_validation as cv
@@ -16,6 +21,11 @@ from homeassistant.helpers.typing import ConfigType, DiscoveryInfoType
 
 from .const import CONF_BASE_URL, DEFAULT_URL, LOGGER
 
+ATTR_MEDIA = "media"
+ATTR_TARGET = "target"
+ATTR_MEDIA_WARNING = "media_warning"
+ATTR_CONTENT_WARNING = "content_warning"
+
 PLATFORM_SCHEMA = PLATFORM_SCHEMA.extend(
     {
         vol.Required(CONF_ACCESS_TOKEN): cv.string,
@@ -60,8 +70,59 @@ class MastodonNotificationService(BaseNotificationService):
         self._api = api
 
     def send_message(self, message: str = "", **kwargs: Any) -> None:
-        """Send a message to a user."""
+        """Toot a message, with media perhaps."""
+        data = kwargs.get(ATTR_DATA)
+
+        media = None
+        mediadata = None
+        target = None
+        sensitive = False
+        content_warning = None
+
+        if data:
+            media = data.get(ATTR_MEDIA)
+            if media:
+                if not self.hass.config.is_allowed_path(media):
+                    LOGGER.warning("'%s' is not a whitelisted directory", media)
+                    return
+                mediadata = self._upload_media(media)
+
+            target = data.get(ATTR_TARGET)
+            sensitive = data.get(ATTR_MEDIA_WARNING)
+            content_warning = data.get(ATTR_CONTENT_WARNING)
+
+        if mediadata:
+            try:
+                self._api.status_post(
+                    message,
+                    media_ids=mediadata["id"],
+                    sensitive=sensitive,
+                    visibility=target,
+                    spoiler_text=content_warning,
+                )
+            except MastodonAPIError:
+                LOGGER.error("Unable to send message")
+        else:
+            try:
+                self._api.status_post(
+                    message, visibility=target, spoiler_text=content_warning
+                )
+            except MastodonAPIError:
+                LOGGER.error("Unable to send message")
+
+    def _upload_media(self, media_path: Any = None) -> Any:
+        """Upload media."""
+        with open(media_path, "rb"):
+            media_type = self._media_type(media_path)
         try:
-            self._api.toot(message)
+            mediadata = self._api.media_post(media_path, mime_type=media_type)
         except MastodonAPIError:
-            LOGGER.error("Unable to send message")
+            LOGGER.error(f"Unable to upload image {media_path}")
+
+        return mediadata
+
+    def _media_type(self, media_path: Any = None) -> Any:
+        """Get media Type."""
+        (media_type, _) = mimetypes.guess_type(media_path)
+
+        return media_type