diff --git a/dev-packages/node-core-integration-tests/suites/system-error/basic-pii.mjs b/dev-packages/node-core-integration-tests/suites/system-error/basic-pii.mjs
new file mode 100644
index 000000000000..1dd8c40c6ccf
--- /dev/null
+++ b/dev-packages/node-core-integration-tests/suites/system-error/basic-pii.mjs
@@ -0,0 +1,11 @@
+import * as Sentry from '@sentry/node-core';
+import { loggingTransport } from '@sentry-internal/node-integration-tests';
+import { readFileSync } from 'fs';
+
+Sentry.init({
+  dsn: 'https://public@dsn.ingest.sentry.io/1337',
+  transport: loggingTransport,
+  sendDefaultPii: true,
+});
+
+readFileSync('non-existent-file.txt');
diff --git a/dev-packages/node-core-integration-tests/suites/system-error/basic.mjs b/dev-packages/node-core-integration-tests/suites/system-error/basic.mjs
new file mode 100644
index 000000000000..5321dd062fa2
--- /dev/null
+++ b/dev-packages/node-core-integration-tests/suites/system-error/basic.mjs
@@ -0,0 +1,10 @@
+import * as Sentry from '@sentry/node-core';
+import { loggingTransport } from '@sentry-internal/node-integration-tests';
+import { readFileSync } from 'fs';
+
+Sentry.init({
+  dsn: 'https://public@dsn.ingest.sentry.io/1337',
+  transport: loggingTransport,
+});
+
+readFileSync('non-existent-file.txt');
diff --git a/dev-packages/node-core-integration-tests/suites/system-error/test.ts b/dev-packages/node-core-integration-tests/suites/system-error/test.ts
new file mode 100644
index 000000000000..1725bd11a0f6
--- /dev/null
+++ b/dev-packages/node-core-integration-tests/suites/system-error/test.ts
@@ -0,0 +1,59 @@
+import { afterAll, describe, test } from 'vitest';
+import { cleanupChildProcesses, createRunner } from '../../utils/runner';
+
+afterAll(() => {
+  cleanupChildProcesses();
+});
+
+describe('SystemError integration', () => {
+  test('sendDefaultPii: false', async () => {
+    await createRunner(__dirname, 'basic.mjs')
+      .expect({
+        event: {
+          contexts: {
+            node_system_error: {
+              errno: -2,
+              code: 'ENOENT',
+              syscall: 'open',
+            },
+          },
+          exception: {
+            values: [
+              {
+                type: 'Error',
+                value: 'ENOENT: no such file or directory, open',
+              },
+            ],
+          },
+        },
+      })
+      .start()
+      .completed();
+  });
+
+  test('sendDefaultPii: true', async () => {
+    await createRunner(__dirname, 'basic-pii.mjs')
+      .expect({
+        event: {
+          contexts: {
+            node_system_error: {
+              errno: -2,
+              code: 'ENOENT',
+              syscall: 'open',
+              path: 'non-existent-file.txt',
+            },
+          },
+          exception: {
+            values: [
+              {
+                type: 'Error',
+                value: 'ENOENT: no such file or directory, open',
+              },
+            ],
+          },
+        },
+      })
+      .start()
+      .completed();
+  });
+});
diff --git a/packages/astro/src/index.server.ts b/packages/astro/src/index.server.ts
index a9e81aee7db5..3b2f589f7fc2 100644
--- a/packages/astro/src/index.server.ts
+++ b/packages/astro/src/index.server.ts
@@ -124,6 +124,7 @@ export {
   startSession,
   startSpan,
   startSpanManual,
+  systemErrorIntegration,
   tediousIntegration,
   trpcMiddleware,
   updateSpanName,
diff --git a/packages/aws-serverless/src/index.ts b/packages/aws-serverless/src/index.ts
index b99c481fd1d3..8cbcd31c50a5 100644
--- a/packages/aws-serverless/src/index.ts
+++ b/packages/aws-serverless/src/index.ts
@@ -114,6 +114,7 @@ export {
   spanToJSON,
   spanToTraceHeader,
   spanToBaggageHeader,
+  systemErrorIntegration,
   trpcMiddleware,
   updateSpanName,
   supabaseIntegration,
diff --git a/packages/google-cloud-serverless/src/index.ts b/packages/google-cloud-serverless/src/index.ts
index 8339e95c77a3..26ed56f031d8 100644
--- a/packages/google-cloud-serverless/src/index.ts
+++ b/packages/google-cloud-serverless/src/index.ts
@@ -115,6 +115,7 @@ export {
   trpcMiddleware,
   updateSpanName,
   supabaseIntegration,
+  systemErrorIntegration,
   instrumentSupabaseClient,
   zodErrorsIntegration,
   profiler,
diff --git a/packages/node-core/src/index.ts b/packages/node-core/src/index.ts
index 6d478ea912e9..cf581bd63b66 100644
--- a/packages/node-core/src/index.ts
+++ b/packages/node-core/src/index.ts
@@ -21,6 +21,7 @@ export { onUnhandledRejectionIntegration } from './integrations/onunhandledrejec
 export { anrIntegration, disableAnrDetectionForCallback } from './integrations/anr';
 
 export { spotlightIntegration } from './integrations/spotlight';
+export { systemErrorIntegration } from './integrations/systemError';
 export { childProcessIntegration } from './integrations/childProcess';
 export { createSentryWinstonTransport } from './integrations/winston';
 
diff --git a/packages/node-core/src/integrations/systemError.ts b/packages/node-core/src/integrations/systemError.ts
new file mode 100644
index 000000000000..f1fd3f4db0dc
--- /dev/null
+++ b/packages/node-core/src/integrations/systemError.ts
@@ -0,0 +1,76 @@
+import * as util from 'node:util';
+import { defineIntegration } from '@sentry/core';
+
+const INTEGRATION_NAME = 'NodeSystemError';
+
+type SystemErrorContext = {
+  dest?: string; // If present, the file path destination when reporting a file system error
+  errno: number; // The system-provided error number
+  path?: string; // If present, the file path when reporting a file system error
+};
+
+type SystemError = Error & SystemErrorContext;
+
+function isSystemError(error: unknown): error is SystemError {
+  if (!(error instanceof Error)) {
+    return false;
+  }
+
+  if (!('errno' in error) || typeof error.errno !== 'number') {
+    return false;
+  }
+
+  // Appears this is the recommended way to check for Node.js SystemError
+  // https://github.com/nodejs/node/issues/46869
+  return util.getSystemErrorMap().has(error.errno);
+}
+
+type Options = {
+  /**
+   * If true, includes the `path` and `dest` properties in the error context.
+   */
+  includePaths?: boolean;
+};
+
+/**
+ * Captures context for Node.js SystemError errors.
+ */
+export const systemErrorIntegration = defineIntegration((options: Options = {}) => {
+  return {
+    name: INTEGRATION_NAME,
+    processEvent: (event, hint, client) => {
+      if (!isSystemError(hint.originalException)) {
+        return event;
+      }
+
+      const error = hint.originalException;
+
+      const errorContext: SystemErrorContext = {
+        ...error,
+      };
+
+      if (!client.getOptions().sendDefaultPii && options.includePaths !== true) {
+        delete errorContext.path;
+        delete errorContext.dest;
+      }
+
+      event.contexts = {
+        ...event.contexts,
+        node_system_error: errorContext,
+      };
+
+      for (const exception of event.exception?.values || []) {
+        if (exception.value) {
+          if (error.path && exception.value.includes(error.path)) {
+            exception.value = exception.value.replace(`'${error.path}'`, '').trim();
+          }
+          if (error.dest && exception.value.includes(error.dest)) {
+            exception.value = exception.value.replace(`'${error.dest}'`, '').trim();
+          }
+        }
+      }
+
+      return event;
+    },
+  };
+});
diff --git a/packages/node-core/src/sdk/index.ts b/packages/node-core/src/sdk/index.ts
index eb2807193b9b..e5b12166d962 100644
--- a/packages/node-core/src/sdk/index.ts
+++ b/packages/node-core/src/sdk/index.ts
@@ -32,6 +32,7 @@ import { onUncaughtExceptionIntegration } from '../integrations/onuncaughtexcept
 import { onUnhandledRejectionIntegration } from '../integrations/onunhandledrejection';
 import { processSessionIntegration } from '../integrations/processSession';
 import { INTEGRATION_NAME as SPOTLIGHT_INTEGRATION_NAME, spotlightIntegration } from '../integrations/spotlight';
+import { systemErrorIntegration } from '../integrations/systemError';
 import { makeNodeTransport } from '../transports';
 import type { NodeClientOptions, NodeOptions } from '../types';
 import { isCjs } from '../utils/commonjs';
@@ -52,6 +53,7 @@ export function getDefaultIntegrations(): Integration[] {
     functionToStringIntegration(),
     linkedErrorsIntegration(),
     requestDataIntegration(),
+    systemErrorIntegration(),
     // Native Wrappers
     consoleIntegration(),
     httpIntegration(),
diff --git a/packages/node/src/index.ts b/packages/node/src/index.ts
index bba0f98bc75e..da97071bdd32 100644
--- a/packages/node/src/index.ts
+++ b/packages/node/src/index.ts
@@ -165,6 +165,7 @@ export {
   childProcessIntegration,
   createSentryWinstonTransport,
   SentryContextManager,
+  systemErrorIntegration,
   generateInstrumentOnce,
   getSentryRelease,
   defaultStackParser,
diff --git a/packages/sveltekit/src/server/index.ts b/packages/sveltekit/src/server/index.ts
index 043bad823bb3..56400dcc5423 100644
--- a/packages/sveltekit/src/server/index.ts
+++ b/packages/sveltekit/src/server/index.ts
@@ -113,6 +113,7 @@ export {
   startSession,
   startSpan,
   startSpanManual,
+  systemErrorIntegration,
   tediousIntegration,
   trpcMiddleware,
   updateSpanName,