diff --git a/CHANGELOG.md b/CHANGELOG.md
index 0704c6a4..e6ae8b98 100644
--- a/CHANGELOG.md
+++ b/CHANGELOG.md
@@ -64,6 +64,16 @@ All notable changes to vouch are documented here. Format follows
   per-prompt block, the session banner, `vouch status` and the opt-in
   question all say so rather than calling it "this repo's" knowledge.
 
+### Fixed
+- `vouch fsck` no longer crashes with a `KeyError` on a KB that has an
+  approved delete proposal. the decided-proposals check only knew the
+  create kinds, so the first approved delete broke fsck permanently.
+  approved deletes are now checked for the inverse drift — a target
+  artifact still on disk is reported as `decided_delete_artifact_present`,
+  a missing or unknown target kind as `decided_delete_invalid_target_kind`
+  — and an artifact removed by an approved delete no longer misreports
+  its create proposal as `decided_missing_artifact`.
+
 ## [1.5.0] — 2026-07-20
 
 ### Added
diff --git a/src/vouch/health.py b/src/vouch/health.py
index 6c8df7d6..ca3207b4 100644
--- a/src/vouch/health.py
+++ b/src/vouch/health.py
@@ -436,6 +436,10 @@ def _check_decided_proposals(
     A crash between `put_<kind>()` and `move_proposal_to_decided()` would
     leave a `decided/` entry without a matching artifact (or vice versa);
     surface the artifact-missing case so an operator can investigate.
+    approved delete proposals promise the inverse — the target artifact is
+    gone — so for those the still-present case is surfaced instead, and an
+    artifact a later approved delete removed is not missing: the delete
+    explains its absence.
     """
     relations = {r.id for r in store.list_relations()}
     presence: dict[ProposalKind, set[str]] = {
@@ -444,7 +448,14 @@ def _check_decided_proposals(
         ProposalKind.ENTITY: set(entities),
         ProposalKind.RELATION: relations,
     }
-    for pr in store.list_proposals(ProposalStatus.APPROVED):
+    presence_by_target_kind = {kind.value: ids for kind, ids in presence.items()}
+    approved = store.list_proposals(ProposalStatus.APPROVED)
+    deleted_by_gate = {
+        (pr.payload.get("target_kind"), pr.payload.get("id"))
+        for pr in approved
+        if pr.kind is ProposalKind.DELETE and isinstance(pr.payload, dict)
+    }
+    for pr in approved:
         artifact_id = pr.payload.get("id") if isinstance(pr.payload, dict) else None
         if not artifact_id:
             findings.append(
@@ -456,7 +467,35 @@ def _check_decided_proposals(
                 )
             )
             continue
-        if artifact_id not in presence[pr.kind]:
+        if pr.kind is ProposalKind.DELETE:
+            target_kind = pr.payload.get("target_kind", "")
+            target_ids = presence_by_target_kind.get(target_kind)
+            if target_ids is None:
+                findings.append(
+                    Finding(
+                        "error",
+                        "decided_delete_invalid_target_kind",
+                        f"approved delete proposal {pr.id} has a missing or "
+                        f"unknown target_kind {target_kind!r}",
+                        [pr.id, artifact_id],
+                    )
+                )
+            elif artifact_id in target_ids:
+                findings.append(
+                    Finding(
+                        "error",
+                        "decided_delete_artifact_present",
+                        f"approved delete proposal {pr.id} promised "
+                        f"{target_kind} {artifact_id} removed but the "
+                        f"artifact is still on disk",
+                        [pr.id, artifact_id],
+                    )
+                )
+            continue
+        if (
+            artifact_id not in presence[pr.kind]
+            and (pr.kind.value, artifact_id) not in deleted_by_gate
+        ):
             findings.append(
                 Finding(
                     "error",
diff --git a/tests/test_health.py b/tests/test_health.py
index 26b15a6b..9840280c 100644
--- a/tests/test_health.py
+++ b/tests/test_health.py
@@ -6,8 +6,15 @@
 
 import pytest
 
-from vouch import health, index_db
-from vouch.models import Claim, ClaimStatus, Proposal, ProposalKind, ProposalStatus
+from vouch import health, index_db, proposals
+from vouch.models import (
+    Claim,
+    ClaimStatus,
+    Entity,
+    Proposal,
+    ProposalKind,
+    ProposalStatus,
+)
 from vouch.storage import KBStore, _yaml_dump
 
 
@@ -296,6 +303,75 @@ def test_fsck_decided_missing_artifact(store: KBStore) -> None:
     assert "decided_missing_artifact" in codes
 
 
+def _approve_entity_delete(store: KBStore) -> Entity:
+    """Create and then delete an entity through the real review gate."""
+    created = proposals.propose_entity(
+        store, name="acme example", entity_type="company", proposed_by="agent",
+    )
+    entity = proposals.approve(store, created.id, approved_by="reviewer")
+    assert isinstance(entity, Entity)
+    deletion = proposals.propose_delete(
+        store, target_kind="entity", target_id=entity.id, proposed_by="agent",
+    )
+    proposals.approve(store, deletion.id, approved_by="reviewer")
+    return entity
+
+
+def test_fsck_approved_delete_with_artifact_gone_is_clean(store: KBStore) -> None:
+    """An approved delete whose target is gone is the healthy case.
+
+    Regression: the presence map only covered create kinds, so any KB with
+    an approved delete proposal crashed fsck with a KeyError.
+    """
+    _approve_entity_delete(store)
+
+    report = health.fsck(store)
+    codes = {f.code for f in report.findings}
+    assert "decided_missing_artifact" not in codes
+    assert "decided_delete_artifact_present" not in codes
+    assert report.ok is True
+
+
+def test_fsck_flags_approved_delete_artifact_still_present(store: KBStore) -> None:
+    """An approved delete whose target survived on disk is the drift case —
+    a crash between the artifact removal and the decided-move leaves the
+    target in place; simulate it by recreating the entity after approval."""
+    entity = _approve_entity_delete(store)
+    store.put_entity(entity)
+
+    report = health.fsck(store)
+    codes = {f.code for f in report.findings}
+    assert "decided_delete_artifact_present" in codes
+    assert report.ok is False
+
+
+def test_fsck_flags_approved_delete_with_invalid_target_kind(
+    store: KBStore,
+) -> None:
+    """A decided delete with an unknown target_kind is drift, not clean.
+
+    No current write path produces this (propose_delete validates the
+    kind), so hand-land the decided YAML the way an older writer or a
+    hand edit could have left it — fsck is the after-the-fact net.
+    """
+    store.put_proposal(Proposal(
+        id="prop-del-bad",
+        kind=ProposalKind.DELETE,
+        proposed_by="agent",
+        payload={"target_kind": "wormhole", "id": "x", "snapshot": {}},
+        status=ProposalStatus.APPROVED,
+    ))
+    src_path = store.kb_dir / "proposed" / "prop-del-bad.yaml"
+    dst_path = store.kb_dir / "decided" / "prop-del-bad.yaml"
+    dst_path.write_text(src_path.read_text())
+    src_path.unlink()
+
+    report = health.fsck(store)
+    codes = {f.code for f in report.findings}
+    assert "decided_delete_invalid_target_kind" in codes
+    assert report.ok is False
+
+
 def test_fsck_index_orphan_row(store: KBStore) -> None:
     """An FTS5 row with no on-disk claim is reported as an index orphan."""
     src = store.put_source(b"e")