diff --git a/packages/instrumentation-undici/.eslintrc.js b/packages/instrumentation-undici/.eslintrc.cjs
similarity index 100%
rename from packages/instrumentation-undici/.eslintrc.js
rename to packages/instrumentation-undici/.eslintrc.cjs
diff --git a/packages/instrumentation-undici/package.json b/packages/instrumentation-undici/package.json
index 6be3ea1a36..f0a67d7ac7 100644
--- a/packages/instrumentation-undici/package.json
+++ b/packages/instrumentation-undici/package.json
@@ -3,25 +3,25 @@
   "version": "0.14.0",
   "description": "OpenTelemetry instrumentation for `undici` http client and Node.js fetch()",
   "main": "build/src/index.js",
+  "module": "build/esm/index.js",
   "types": "build/src/index.d.ts",
+  "type": "module",
   "repository": {
     "type": "git",
     "url": "https://github.com/open-telemetry/opentelemetry-js-contrib.git",
     "directory": "packages/instrumentation-undici"
   },
   "scripts": {
-    "clean": "rimraf build/*",
-    "compile": "tsc -p .",
+    "clean": "tsc --build --clean tsconfig.json tsconfig.cjs.json",
+    "compile": "tsc --build tsconfig.json tsconfig.cjs.json && echo '{\"type\":\"commonjs\"}' > build/cjs/package.json",
     "compile:with-dependencies": "nx run-many -t compile -p @opentelemetry/instrumentation-undici",
-    "lint": "eslint . --ext=ts,js,mjs",
-    "lint:fix": "eslint . --ext=ts,js,mjs --fix",
+    "lint": "eslint . --ext .ts",
+    "lint:fix": "eslint . --ext .ts --fix",
     "prepublishOnly": "npm run compile",
     "tdd": "npm run test -- --watch-extensions ts --watch",
-    "test": "nyc --no-clean mocha test/**/*.test.ts",
+    "test": "nyc mocha --loader=ts-node/esm test/**/*.test.ts",
     "test-all-versions": "tav",
-    "test-merge-coverage": "nyc merge .nyc_output coverage/coverage-final.json",
-    "version:update": "node ../../scripts/version-update.js",
-    "watch": "tsc -w"
+    "version:update": "node ../../scripts/version-update.js"
   },
   "keywords": [
     "opentelemetry",
@@ -36,10 +36,23 @@
   "engines": {
     "node": "^18.19.0 || >=20.6.0"
   },
+  "exports": {
+    "import": {
+      "types": "./build/src/index.d.ts",
+      "default": "./build/src/index.js"
+    },
+    "require": {
+      "types": "./build/cjs/index.d.ts",
+      "default": "./build/cjs/index.js"
+    }
+  },
   "files": [
     "build/src/**/*.js",
     "build/src/**/*.js.map",
-    "build/src/**/*.d.ts"
+    "build/src/**/*.d.ts",
+    "build/cjs/**/*.js",
+    "build/cjs/**/*.js.map",
+    "build/cjs/**/*.d.ts"
   ],
   "publishConfig": {
     "access": "public"
diff --git a/packages/instrumentation-undici/src/index.ts b/packages/instrumentation-undici/src/index.ts
index 942dd61bb7..c0de41cfdd 100644
--- a/packages/instrumentation-undici/src/index.ts
+++ b/packages/instrumentation-undici/src/index.ts
@@ -14,7 +14,7 @@
  * limitations under the License.
  */
 
-export { UndiciInstrumentation } from './undici';
+export { UndiciInstrumentation } from './undici.js';
 export type {
   IgnoreRequestFunction,
   RequestHookFunction,
@@ -23,4 +23,4 @@ export type {
   UndiciInstrumentationConfig,
   UndiciRequest,
   UndiciResponse,
-} from './types';
+} from './types.js';
diff --git a/packages/instrumentation-undici/src/internal-types.ts b/packages/instrumentation-undici/src/internal-types.ts
index e6b2fff535..3e7c2645a0 100644
--- a/packages/instrumentation-undici/src/internal-types.ts
+++ b/packages/instrumentation-undici/src/internal-types.ts
@@ -14,7 +14,7 @@
  * limitations under the License.
  */
 
-import { UndiciRequest, UndiciResponse } from './types';
+import { UndiciRequest, UndiciResponse } from './types.js';
 
 export interface ListenerRecord {
   name: string;
diff --git a/packages/instrumentation-undici/src/undici.ts b/packages/instrumentation-undici/src/undici.ts
index 519ba4691f..666f1bce6f 100644
--- a/packages/instrumentation-undici/src/undici.ts
+++ b/packages/instrumentation-undici/src/undici.ts
@@ -35,7 +35,7 @@ import {
 } from '@opentelemetry/api';
 
 /** @knipignore */
-import { PACKAGE_NAME, PACKAGE_VERSION } from './version';
+import { PACKAGE_NAME, PACKAGE_VERSION } from './version.js';
 
 import {
   ListenerRecord,
@@ -43,9 +43,9 @@ import {
   RequestMessage,
   RequestTrailersMessage,
   ResponseHeadersMessage,
-} from './internal-types';
-import { UndiciInstrumentationConfig, UndiciRequest } from './types';
-import { SemanticAttributes } from './enums/SemanticAttributes';
+} from './internal-types.js';
+import { UndiciInstrumentationConfig, UndiciRequest } from './types.js';
+import { SemanticAttributes } from './enums/SemanticAttributes.js';
 import {
   hrTime,
   hrTimeDuration,
diff --git a/packages/instrumentation-undici/test/fetch.test.ts b/packages/instrumentation-undici/test/fetch.test.ts
index 7e389838bb..becc772f5d 100644
--- a/packages/instrumentation-undici/test/fetch.test.ts
+++ b/packages/instrumentation-undici/test/fetch.test.ts
@@ -29,11 +29,11 @@ import {
 } from '@opentelemetry/sdk-trace-base';
 import { NodeTracerProvider } from '@opentelemetry/sdk-trace-node';
 
-import { UndiciInstrumentation } from '../src/undici';
+import { UndiciInstrumentation } from '../src/undici.js';
 
-import { MockPropagation } from './utils/mock-propagation';
-import { MockServer } from './utils/mock-server';
-import { assertSpan } from './utils/assertSpan';
+import { MockPropagation } from './utils/mock-propagation.js';
+import { MockServer } from './utils/mock-server.js';
+import { assertSpan } from './utils/assertSpan.js';
 
 describe('UndiciInstrumentation `fetch` tests', function () {
   let instrumentation: UndiciInstrumentation;
diff --git a/packages/instrumentation-undici/test/metrics.test.ts b/packages/instrumentation-undici/test/metrics.test.ts
index bca94ac6e9..ecad70cdcb 100644
--- a/packages/instrumentation-undici/test/metrics.test.ts
+++ b/packages/instrumentation-undici/test/metrics.test.ts
@@ -25,11 +25,11 @@ import {
   MeterProvider,
 } from '@opentelemetry/sdk-metrics';
 
-import { UndiciInstrumentation } from '../src/undici';
+import { UndiciInstrumentation } from '../src/undici.js';
 
-import { MockServer } from './utils/mock-server';
-import { MockMetricsReader } from './utils/mock-metrics-reader';
-import { SemanticAttributes } from '../src/enums/SemanticAttributes';
+import { MockServer } from './utils/mock-server.js';
+import { MockMetricsReader } from './utils/mock-metrics-reader.js';
+import { SemanticAttributes } from '../src/enums/SemanticAttributes.js';
 
 describe('UndiciInstrumentation metrics tests', function () {
   let instrumentation: UndiciInstrumentation;
diff --git a/packages/instrumentation-undici/test/undici.test.ts b/packages/instrumentation-undici/test/undici.test.ts
index 2a124fb199..c44ea33f37 100644
--- a/packages/instrumentation-undici/test/undici.test.ts
+++ b/packages/instrumentation-undici/test/undici.test.ts
@@ -15,6 +15,7 @@
  */
 import * as assert from 'assert';
 import { Writable } from 'stream';
+import { createRequire } from 'module';
 
 import {
   INVALID_SPAN_CONTEXT,
@@ -31,14 +32,20 @@ import {
 } from '@opentelemetry/sdk-trace-base';
 import { NodeTracerProvider } from '@opentelemetry/sdk-trace-node';
 
-import { UndiciInstrumentation } from '../src/undici';
+import { UndiciInstrumentation } from '../src/undici.js';
 
-import { MockPropagation } from './utils/mock-propagation';
-import { MockServer } from './utils/mock-server';
-import { assertSpan } from './utils/assertSpan';
+import { MockPropagation } from './utils/mock-propagation.js';
+import { MockServer } from './utils/mock-server.js';
+import { assertSpan } from './utils/assertSpan.js';
 
 import type { fetch, stream, request, Client, Dispatcher } from 'undici';
 
+// NOTE: now this test is compiled to ESM and `require` is not available.
+// So we do this to not make a refactor on code that is not publishwd to the user.
+// This could be handled once https://github.com/open-telemetry/opentelemetry-js/issues/4898
+// is closed.
+const require = createRequire(import.meta.url);
+
 // Undici docs (https://github.com/nodejs/undici#garbage-collection) suggest
 // that an undici response body should always be consumed.
 async function consumeResponseBody(body: Dispatcher.ResponseData['body']) {
diff --git a/packages/instrumentation-undici/test/utils/assertSpan.ts b/packages/instrumentation-undici/test/utils/assertSpan.ts
index c5d584dd46..271ace0a9a 100644
--- a/packages/instrumentation-undici/test/utils/assertSpan.ts
+++ b/packages/instrumentation-undici/test/utils/assertSpan.ts
@@ -22,7 +22,7 @@ import {
 import { hrTimeToNanoseconds } from '@opentelemetry/core';
 import { ReadableSpan } from '@opentelemetry/sdk-trace-base';
 import * as assert from 'assert';
-import { SemanticAttributes } from '../../src/enums/SemanticAttributes';
+import { SemanticAttributes } from '../../src/enums/SemanticAttributes.js';
 
 type IncomingHttpHeaders = Record<string, string | string[] | undefined>;
 
diff --git a/packages/instrumentation-undici/tsconfig.cjs.json b/packages/instrumentation-undici/tsconfig.cjs.json
new file mode 100644
index 0000000000..9b87ebb819
--- /dev/null
+++ b/packages/instrumentation-undici/tsconfig.cjs.json
@@ -0,0 +1,13 @@
+{
+  "extends": "../../tsconfig.base",
+  "compilerOptions": {
+    "rootDir": "src",
+    "outDir": "build/cjs",
+    "module": "commonjs",
+    "moduleResolution": "node10",
+    "tsBuildInfoFile": "build/cjs/tsconfig.cjs.tsbuildinfo"
+  },
+  "include": [
+    "src/**/*.ts"
+  ]
+}
diff --git a/packages/instrumentation-undici/tsconfig.json b/packages/instrumentation-undici/tsconfig.json
index 4078877ce6..4d1e4c9930 100644
--- a/packages/instrumentation-undici/tsconfig.json
+++ b/packages/instrumentation-undici/tsconfig.json
@@ -1,8 +1,10 @@
 {
-  "extends": "../../tsconfig.base",
+  "extends": "../../tsconfig.base.esm.json",
   "compilerOptions": {
+    "outDir": "build",
     "rootDir": ".",
-    "outDir": "build"
+    "module": "node16",
+    "tsBuildInfoFile": "build/src/tsconfig.esm.tsbuildinfo"
   },
   "include": [
     "src/**/*.ts",