diff --git a/src/core/host_display.cpp b/src/core/host_display.cpp
index b765e27c5..eb9983cfb 100644
--- a/src/core/host_display.cpp
+++ b/src/core/host_display.cpp
@@ -227,12 +227,39 @@ void HostDisplay::CalculateDrawRect(s32 window_width, s32 window_height, float*
     apply_aspect_ratio ?
       (display_aspect_ratio / (static_cast<float>(m_display_width) / static_cast<float>(m_display_height))) :
       1.0f;
-  const float display_width = static_cast<float>(m_display_width) * x_scale;
-  const float display_height = static_cast<float>(m_display_height);
-  const float active_left = static_cast<float>(m_display_active_left) * x_scale;
-  const float active_top = static_cast<float>(m_display_active_top);
-  const float active_width = static_cast<float>(m_display_active_width) * x_scale;
-  const float active_height = static_cast<float>(m_display_active_height);
+  const float display_width_stretched = static_cast<float>(m_display_width) * x_scale;
+  const float display_width_pre =
+    (display_width_stretched > static_cast<float>(m_display_width)) ?
+      display_width_stretched : static_cast<float>(m_display_width);
+  const float display_width = g_settings.display_always_stretch_horizontally ? display_width_stretched :
+    display_width_pre;
+  const float active_left_stretched = static_cast<float>(m_display_active_left) * x_scale;
+  const float active_left_pre =
+    (display_width_stretched > static_cast<float>(m_display_width)) ?
+      active_left_stretched : static_cast<float>(m_display_active_left);
+  const float active_left = g_settings.display_always_stretch_horizontally ? active_left_stretched :
+    active_left_pre;
+  const float active_width_stretched = static_cast<float>(m_display_active_width) * x_scale;
+  const float active_width_pre =
+    (display_width_stretched > static_cast<float>(m_display_width)) ?
+      active_width_stretched : static_cast<float>(m_display_active_width);
+  const float active_width = g_settings.display_always_stretch_horizontally ? active_width_stretched :
+    active_width_pre;
+  const float display_height_pre =
+    (display_width_stretched < static_cast<float>(m_display_width)) ?
+      static_cast<float>(m_display_height) / x_scale : static_cast<float>(m_display_height);
+  const float display_height = g_settings.display_always_stretch_horizontally ?
+    static_cast<float>(m_display_height) : display_height_pre;
+  const float active_top_pre =
+    (display_width_stretched < static_cast<float>(m_display_width)) ?
+      static_cast<float>(m_display_active_top) / x_scale : static_cast<float>(m_display_active_top);
+  const float active_top = g_settings.display_always_stretch_horizontally ?
+    static_cast<float>(m_display_active_top) : active_top_pre;
+  const float active_height_pre =
+    (display_width_stretched < static_cast<float>(m_display_width)) ?
+      static_cast<float>(m_display_active_height) / x_scale : static_cast<float>(m_display_active_height);
+  const float active_height = g_settings.display_always_stretch_horizontally ?
+    static_cast<float>(m_display_active_height) : active_height_pre;
   if (out_x_scale)
     *out_x_scale = x_scale;
 
@@ -360,8 +387,17 @@ std::tuple<float, float> HostDisplay::ConvertWindowCoordinatesToDisplayCoordinat
   const float scaled_display_y = static_cast<float>(window_y) - top_padding;
 
   // scale back to internal resolution
-  const float display_x = scaled_display_x / scale / x_scale;
-  const float display_y = scaled_display_y / scale;
+  const float display_x_stretched = scaled_display_x / scale / x_scale;
+  const float display_x_pre =
+    (display_x_stretched > (scaled_display_x / scale)) ?
+      display_x_stretched : (scaled_display_x / scale);
+  const float display_x = g_settings.display_always_stretch_horizontally ?
+    display_x_stretched : display_x_pre;
+  const float display_y_pre =
+    (display_x_stretched < (scaled_display_x / scale)) ?
+      scaled_display_y / scale * x_scale : scaled_display_y / scale;
+  const float display_y = g_settings.display_always_stretch_horizontally ?
+    scaled_display_y / scale : display_y_pre;
 
   return std::make_tuple(display_x, display_y);
 }
@@ -488,7 +524,20 @@ bool HostDisplay::WriteDisplayTextureToFile(std::string filename, bool full_reso
     const float ss_width_scale = static_cast<float>(m_display_active_width) / static_cast<float>(m_display_width);
     const float ss_height_scale = static_cast<float>(m_display_active_height) / static_cast<float>(m_display_height);
     const float ss_aspect_ratio = m_display_aspect_ratio * ss_width_scale / ss_height_scale;
-    resize_width = static_cast<s32>(static_cast<float>(resize_height) * ss_aspect_ratio);
+    const float resize_width_stretched = static_cast<float>(resize_height) * ss_aspect_ratio;
+    const float resize_width_pre =
+      (static_cast<s32>(resize_width_stretched) > m_display_texture_view_width) ?
+        resize_width_stretched : static_cast<float>(m_display_texture_view_width);
+    resize_width = g_settings.display_always_stretch_horizontally ?
+      static_cast<s32>(resize_width_stretched) : static_cast<s32>(resize_width_pre);
+    if (!g_settings.display_always_stretch_horizontally)
+    {
+      resize_height =
+        (static_cast<s32>(resize_width_stretched) < m_display_texture_view_width) ?
+          static_cast<s32>(static_cast<float>(resize_height) /
+            (m_display_aspect_ratio / (static_cast<float>(m_display_width) / static_cast<float>(m_display_height)))) :
+          resize_height;
+    }
   }
   else
   {
diff --git a/src/core/settings.cpp b/src/core/settings.cpp
index 89b50e158..460c70d2b 100644
--- a/src/core/settings.cpp
+++ b/src/core/settings.cpp
@@ -270,6 +270,7 @@ void Settings::Load(SettingsInterface& si)
   display_show_enhancements = si.GetBoolValue("Display", "ShowEnhancements", false);
   display_all_frames = si.GetBoolValue("Display", "DisplayAllFrames", false);
   display_internal_resolution_screenshots = si.GetBoolValue("Display", "InternalResolutionScreenshots", false);
+  display_always_stretch_horizontally = si.GetBoolValue("Display", "AlwaysStretchHorizontally", false);
   video_sync_enabled = si.GetBoolValue("Display", "VSync", DEFAULT_VSYNC_VALUE);
   display_post_process_chain = si.GetStringValue("Display", "PostProcessChain", "");
   display_max_fps = si.GetFloatValue("Display", "MaxFPS", DEFAULT_DISPLAY_MAX_FPS);
@@ -487,6 +488,7 @@ void Settings::Save(SettingsInterface& si) const
   si.SetBoolValue("Display", "ShowEnhancements", display_show_enhancements);
   si.SetBoolValue("Display", "DisplayAllFrames", display_all_frames);
   si.SetBoolValue("Display", "InternalResolutionScreenshots", display_internal_resolution_screenshots);
+  si.SetBoolValue("Display", "AlwaysStretchHorizontally", display_always_stretch_horizontally);
   si.SetBoolValue("Display", "VSync", video_sync_enabled);
   if (display_post_process_chain.empty())
     si.DeleteValue("Display", "PostProcessChain");
diff --git a/src/core/settings.h b/src/core/settings.h
index 1461a9870..27bfbba86 100644
--- a/src/core/settings.h
+++ b/src/core/settings.h
@@ -143,6 +143,7 @@ struct Settings
   bool display_show_enhancements = false;
   bool display_all_frames = false;
   bool display_internal_resolution_screenshots = false;
+  bool display_always_stretch_horizontally = false;
   bool video_sync_enabled = DEFAULT_VSYNC_VALUE;
   float display_osd_scale = 100.0f;
   float display_max_fps = DEFAULT_DISPLAY_MAX_FPS;
diff --git a/src/duckstation-qt/advancedsettingswidget.cpp b/src/duckstation-qt/advancedsettingswidget.cpp
index a21fc5465..5a3f84d62 100644
--- a/src/duckstation-qt/advancedsettingswidget.cpp
+++ b/src/duckstation-qt/advancedsettingswidget.cpp
@@ -288,6 +288,9 @@ void AdvancedSettingsWidget::addTweakOptions()
   addBooleanTweakOption(m_dialog, m_ui.tweakOptionTable, tr("Use Debug Host GPU Device"), "GPU", "UseDebugDevice",
                         false);
 
+  addBooleanTweakOption(m_dialog, m_ui.tweakOptionTable, tr("Always Stretch Display Horizontally"), "Display",
+                        "AlwaysStretchHorizontally", false);
+
   addBooleanTweakOption(m_dialog, m_ui.tweakOptionTable, tr("Increase Timer Resolution"), "Main",
                         "IncreaseTimerResolution", true);
 
@@ -354,6 +357,7 @@ void AdvancedSettingsWidget::onResetToDefaultClicked()
   sif->DeleteValue("Display", "ActiveEndOffset");
   sif->DeleteValue("Display", "LineStartOffset");
   sif->DeleteValue("Display", "LineEndOffset");
+  sif->DeleteValue("Display", "AlwaysStretchHorizontally");
   sif->DeleteValue("GPU", "Multisamples");
   sif->DeleteValue("GPU", "PerSampleShading");
   sif->DeleteValue("GPU", "PGXPVertexCache");
diff --git a/src/frontend-common/fullscreen_ui.cpp b/src/frontend-common/fullscreen_ui.cpp
index 3ec2dec5d..d308d0f32 100644
--- a/src/frontend-common/fullscreen_ui.cpp
+++ b/src/frontend-common/fullscreen_ui.cpp
@@ -4506,6 +4506,9 @@ void FullscreenUI::DrawAdvancedSettingsPage()
   DrawFloatRangeSetting(bsi, "Display FPS Limit",
                         "Limits how many frames are displayed to the screen. These frames are still rendered.",
                         "Display", "MaxFPS", Settings::DEFAULT_DISPLAY_MAX_FPS, 0.0f, 500.0f, "%.2f FPS");
+  DrawToggleSetting(bsi, "Always Stretch Display Horizontally",
+                    "Enables old DuckStation behavior for Integer Scaling, where the display is always stretched horizontally.",
+                    "Display", "AlwaysStretchHorizontally", false);
 
   MenuHeading("PGXP Settings");