diff --git a/implementation/src/main/java/io/smallrye/mutiny/operators/multi/MultiDemandPausingOp.java b/implementation/src/main/java/io/smallrye/mutiny/operators/multi/MultiDemandPausingOp.java
index 3bfe4a2e9..bd8794d32 100644
--- a/implementation/src/main/java/io/smallrye/mutiny/operators/multi/MultiDemandPausingOp.java
+++ b/implementation/src/main/java/io/smallrye/mutiny/operators/multi/MultiDemandPausingOp.java
@@ -108,6 +108,7 @@ private class PausableProcessor extends MultiOperatorProcessor<T, T> {
         private final AtomicInteger wip = new AtomicInteger();
         private final AtomicInteger strictBoundCounter = new AtomicInteger(0);
         private volatile boolean upstreamCompleted;
+        private final AtomicBoolean clearQueue = new AtomicBoolean();
 
         PausableProcessor(MultiSubscriber<? super T> downstream) {
             super(downstream);
@@ -156,11 +157,18 @@ void drain() {
                     if (!unbounded) {
                         strictBoundCounter.decrementAndGet();
                     }
+                    if (clearQueue.get()) {
+                        break;
+                    }
                     downstream.onItem(item);
                 }
                 if (!paused.get() && upstreamCompleted) {
                     super.onCompletion();
                 }
+                if (clearQueue.compareAndSet(true, false)) {
+                    queue.clear();
+                    strictBoundCounter.set(0);
+                }
                 if (wip.decrementAndGet() == 0) {
                     return;
                 }
@@ -168,9 +176,12 @@ void drain() {
         }
 
         void clearQueue() {
-            if (queue != null) {
-                strictBoundCounter.set(0);
+            if (queue != null && clearQueue.compareAndSet(false, true) && wip.getAndIncrement() == 0) {
+                // nothing was currently dispatched, clearing the queue.
                 queue.clear();
+                clearQueue.set(false);
+                strictBoundCounter.set(0);
+                wip.decrementAndGet();
             }
         }
 
diff --git a/implementation/src/test/java/io/smallrye/mutiny/operators/multi/MultiDemandPausingTest.java b/implementation/src/test/java/io/smallrye/mutiny/operators/multi/MultiDemandPausingTest.java
index 760caf27c..4b29db24e 100644
--- a/implementation/src/test/java/io/smallrye/mutiny/operators/multi/MultiDemandPausingTest.java
+++ b/implementation/src/test/java/io/smallrye/mutiny/operators/multi/MultiDemandPausingTest.java
@@ -709,4 +709,62 @@ public void testMultiplePauseResumeCycles() {
         await().untilAsserted(() -> assertThat(sub.getItems()).hasSize(100));
     }
 
+    @Test
+    public void testConcurrentResumeAndCancel() {
+        DemandPauser pauser = new DemandPauser();
+
+        // Slow consumer that adds delay to each item processing
+        AssertSubscriber<Integer> sub = Multi.createFrom().ticks().every(Duration.ofMillis(1))
+                .map(Long::intValue)
+                .select().first(1000)
+                .pauseDemand()
+                .bufferStrategy(BackPressureStrategy.BUFFER)
+                .bufferUnconditionally()
+                .using(pauser)
+                .invoke(ignored -> {
+                    try {
+                        // Slow consumer - 10ms per item to keep drain loop busy
+                        Thread.sleep(50);
+                    } catch (InterruptedException e) {
+                        Thread.currentThread().interrupt();
+                    }
+                })
+                .subscribe().withSubscriber(AssertSubscriber.create(Long.MAX_VALUE));
+
+        // Wait for some items to arrive
+        await().untilAsserted(() -> assertThat(sub.getItems()).hasSizeGreaterThan(10));
+
+        // Pause to let buffer fill up with lots of items
+        pauser.pause();
+        await().pollDelay(Duration.ofMillis(200))
+                .untilAsserted(() -> assertThat(pauser.bufferSize()).isGreaterThan(100));
+
+        int bufferSize = pauser.bufferSize();
+        assertThat(bufferSize).isGreaterThan(100);
+
+        // Resume and clear at the same time from different threads
+        // This reproduces the race condition: drain loop starts and clearQueue is called concurrently
+        Thread resumeThread = new Thread(() -> pauser.resume());
+        Thread clearThread = new Thread(() -> sub.cancel());
+
+        resumeThread.start();
+        clearThread.start();
+
+        // Wait for both operations to complete
+        await().untilAsserted(() -> {
+            assertThat(resumeThread.isAlive()).isFalse();
+            assertThat(clearThread.isAlive()).isFalse();
+        });
+
+        // No concurrent modification exception should occur
+        assertThat(sub.getFailure()).isNull();
+
+        // Buffer should be cleared
+        await().untilAsserted(() -> assertThat(pauser.bufferSize()).isEqualTo(0));
+
+        // Stream should continue to work normally
+        await().pollDelay(Duration.ofMillis(200)).until(() -> true);
+        assertThat(sub.getItems()).hasSizeGreaterThan(0);
+    }
+
 }