diff --git a/Source/Core/AudioCommon/CubebStream.cpp b/Source/Core/AudioCommon/CubebStream.cpp
index da515aa8f3..768ea38467 100644
--- a/Source/Core/AudioCommon/CubebStream.cpp
+++ b/Source/Core/AudioCommon/CubebStream.cpp
@@ -37,7 +37,7 @@ bool CubebStream::Init()
   if (!m_ctx)
     return false;
 
-  m_stereo = !SConfig::GetInstance().bDPL2Decoder;
+  m_stereo = !SConfig::GetInstance().bDPL2Decoder || SConfig::GetInstance().bDSPHLE;
 
   cubeb_stream_params params;
   params.rate = m_mixer->GetSampleRate();
diff --git a/Source/Core/AudioCommon/Enums.h b/Source/Core/AudioCommon/Enums.h
index 20c34779a5..ec979ff941 100644
--- a/Source/Core/AudioCommon/Enums.h
+++ b/Source/Core/AudioCommon/Enums.h
@@ -8,8 +8,8 @@ namespace AudioCommon
 {
 enum class DPL2Quality
 {
-  Low = 0,
-  Medium = 1,
+  Lowest = 0,
+  Low = 1,
   High = 2,
   Highest = 3
 };
diff --git a/Source/Core/AudioCommon/Mixer.cpp b/Source/Core/AudioCommon/Mixer.cpp
index 1636c29018..e414538613 100644
--- a/Source/Core/AudioCommon/Mixer.cpp
+++ b/Source/Core/AudioCommon/Mixer.cpp
@@ -20,9 +20,9 @@ static u32 DPL2QualityToFrameBlockSize(AudioCommon::DPL2Quality quality)
 {
   switch (quality)
   {
-  case AudioCommon::DPL2Quality::Low:
+  case AudioCommon::DPL2Quality::Lowest:
     return 512;
-  case AudioCommon::DPL2Quality::Medium:
+  case AudioCommon::DPL2Quality::Low:
     return 1024;
   case AudioCommon::DPL2Quality::Highest:
     return 4096;
diff --git a/Source/Core/AudioCommon/OpenALStream.cpp b/Source/Core/AudioCommon/OpenALStream.cpp
index 4852495d23..51530088b2 100644
--- a/Source/Core/AudioCommon/OpenALStream.cpp
+++ b/Source/Core/AudioCommon/OpenALStream.cpp
@@ -221,7 +221,8 @@ void OpenALStream::SoundLoop()
 
   bool float32_capable = palIsExtensionPresent("AL_EXT_float32") != 0;
   bool surround_capable = palIsExtensionPresent("AL_EXT_MCFORMATS") || IsCreativeXFi();
-  bool use_surround = SConfig::GetInstance().bDPL2Decoder && surround_capable;
+  bool use_surround =
+      SConfig::GetInstance().bDPL2Decoder && surround_capable && !SConfig::GetInstance().bDSPHLE;
 
   // As there is no extension to check for 32-bit fixed point support
   // and we know that only a X-Fi with hardware OpenAL supports it,
diff --git a/Source/Core/AudioCommon/PulseAudioStream.cpp b/Source/Core/AudioCommon/PulseAudioStream.cpp
index e480ed9e6e..3d05cc610b 100644
--- a/Source/Core/AudioCommon/PulseAudioStream.cpp
+++ b/Source/Core/AudioCommon/PulseAudioStream.cpp
@@ -19,7 +19,7 @@ PulseAudio::PulseAudio() = default;
 
 bool PulseAudio::Init()
 {
-  m_stereo = !SConfig::GetInstance().bDPL2Decoder;
+  m_stereo = !SConfig::GetInstance().bDPL2Decoder || SConfig::GetInstance().bDSPHLE;
   m_channels = m_stereo ? 2 : 6;  // will tell PA we use a Stereo or 5.0 channel setup
 
   NOTICE_LOG(AUDIO, "PulseAudio backend using %d channels", m_channels);
diff --git a/Source/Core/DolphinQt/Settings/AudioPane.cpp b/Source/Core/DolphinQt/Settings/AudioPane.cpp
index 8d55b22f63..fa9799022d 100644
--- a/Source/Core/DolphinQt/Settings/AudioPane.cpp
+++ b/Source/Core/DolphinQt/Settings/AudioPane.cpp
@@ -105,7 +105,7 @@ void AudioPane::CreateWidgets()
       tr("Quality of the DPLII decoder. Audio latency increases with quality."));
   m_dolby_quality_slider->setTracking(true);
 
-  m_dolby_quality_low_label = new QLabel(GetDPL2QualityLabel(AudioCommon::DPL2Quality::Low));
+  m_dolby_quality_low_label = new QLabel(GetDPL2QualityLabel(AudioCommon::DPL2Quality::Lowest));
   m_dolby_quality_highest_label =
       new QLabel(GetDPL2QualityLabel(AudioCommon::DPL2Quality::Highest));
   m_dolby_quality_latency_label =
@@ -265,6 +265,11 @@ void AudioPane::SaveSettings()
   auto& settings = Settings::Instance();
 
   // DSP
+  if (SConfig::GetInstance().bDSPHLE != m_dsp_hle->isChecked() ||
+      SConfig::GetInstance().m_DSPEnableJIT != m_dsp_lle->isChecked())
+  {
+    OnDspChanged();
+  }
   SConfig::GetInstance().bDSPHLE = m_dsp_hle->isChecked();
   Config::SetBaseOrCurrent(Config::MAIN_DSP_HLE, m_dsp_hle->isChecked());
   SConfig::GetInstance().m_DSPEnableJIT = m_dsp_lle->isChecked();
@@ -294,7 +299,7 @@ void AudioPane::SaveSettings()
                   static_cast<AudioCommon::DPL2Quality>(m_dolby_quality_slider->value()));
   m_dolby_quality_latency_label->setText(
       GetDPL2ApproximateLatencyLabel(Config::Get(Config::MAIN_DPL2_QUALITY)));
-  if (AudioCommon::SupportsDPL2Decoder(backend))
+  if (AudioCommon::SupportsDPL2Decoder(backend) && !m_dsp_hle->isChecked())
   {
     EnableDolbyQualityWidgets(m_dolby_pro_logic->isChecked());
   }
@@ -324,12 +329,22 @@ void AudioPane::SaveSettings()
   AudioCommon::UpdateSoundStream();
 }
 
+void AudioPane::OnDspChanged()
+{
+  const auto backend = SConfig::GetInstance().sBackend;
+
+  m_dolby_pro_logic->setEnabled(AudioCommon::SupportsDPL2Decoder(backend) &&
+                                !m_dsp_hle->isChecked());
+  EnableDolbyQualityWidgets(AudioCommon::SupportsDPL2Decoder(backend) && !m_dsp_hle->isChecked());
+}
+
 void AudioPane::OnBackendChanged()
 {
   const auto backend = SConfig::GetInstance().sBackend;
 
-  m_dolby_pro_logic->setEnabled(AudioCommon::SupportsDPL2Decoder(backend));
-  EnableDolbyQualityWidgets(AudioCommon::SupportsDPL2Decoder(backend));
+  m_dolby_pro_logic->setEnabled(AudioCommon::SupportsDPL2Decoder(backend) &&
+                                !m_dsp_hle->isChecked());
+  EnableDolbyQualityWidgets(AudioCommon::SupportsDPL2Decoder(backend) && !m_dsp_hle->isChecked());
   if (m_latency_control_supported)
   {
     m_latency_label->setEnabled(AudioCommon::SupportsLatencyControl(backend));
@@ -362,7 +377,7 @@ void AudioPane::OnEmulationStateChanged(bool running)
   m_dsp_interpreter->setEnabled(!running);
   m_backend_label->setEnabled(!running);
   m_backend_combo->setEnabled(!running);
-  if (AudioCommon::SupportsDPL2Decoder(SConfig::GetInstance().sBackend))
+  if (AudioCommon::SupportsDPL2Decoder(SConfig::GetInstance().sBackend) && !m_dsp_hle->isChecked())
   {
     m_dolby_pro_logic->setEnabled(!running);
     EnableDolbyQualityWidgets(!running);
@@ -395,10 +410,10 @@ QString AudioPane::GetDPL2QualityLabel(AudioCommon::DPL2Quality value) const
 {
   switch (value)
   {
+  case AudioCommon::DPL2Quality::Lowest:
+    return tr("Lowest");
   case AudioCommon::DPL2Quality::Low:
     return tr("Low");
-  case AudioCommon::DPL2Quality::Medium:
-    return tr("Medium");
   case AudioCommon::DPL2Quality::Highest:
     return tr("Highest");
   default:
@@ -410,9 +425,9 @@ QString AudioPane::GetDPL2ApproximateLatencyLabel(AudioCommon::DPL2Quality value
 {
   switch (value)
   {
-  case AudioCommon::DPL2Quality::Low:
+  case AudioCommon::DPL2Quality::Lowest:
     return tr("Latency: ~10ms");
-  case AudioCommon::DPL2Quality::Medium:
+  case AudioCommon::DPL2Quality::Low:
     return tr("Latency: ~20ms");
   case AudioCommon::DPL2Quality::Highest:
     return tr("Latency: ~80ms");
diff --git a/Source/Core/DolphinQt/Settings/AudioPane.h b/Source/Core/DolphinQt/Settings/AudioPane.h
index 398f994481..3348e5e908 100644
--- a/Source/Core/DolphinQt/Settings/AudioPane.h
+++ b/Source/Core/DolphinQt/Settings/AudioPane.h
@@ -35,6 +35,7 @@ private:
 
   void OnEmulationStateChanged(bool running);
   void OnBackendChanged();
+  void OnDspChanged();
   void OnVolumeChanged(int volume);
 
   void CheckNeedForLatencyControl();