A free or paid Twilio account is required, along with the Twilio CLI and Node.js version 12.18.4 or above. The user creates a serverless project using Twilio's Serverless Toolkit, which includes deploying a backend for a video app that allows users to join and leave video calls with friends and family. The process involves generating an access token, creating buttons to enter and leave the video call, customizing the web page with HTML and CSS, and deploying the project within seconds using Twilio's deployment command. The project is then deployed on GitHub and can be accessed via a URL, allowing users to join and interact with each other in real-time.