diff --git a/src/core/host_interface.cpp b/src/core/host_interface.cpp
index fba13005e..f72b38c8b 100644
--- a/src/core/host_interface.cpp
+++ b/src/core/host_interface.cpp
@@ -12,6 +12,7 @@ HostInterface::~HostInterface() = default;
 bool HostInterface::InitializeSystem(const char* filename, const char* exp1_filename)
 {
   Settings settings;
+  settings.memory_card_a_filename = "memory_card_a.mcd";
 
   m_system = std::make_unique<System>(this, settings);
   if (!m_system->Initialize())
diff --git a/src/core/memory_card.cpp b/src/core/memory_card.cpp
index 2aec2c2a3..3b900478c 100644
--- a/src/core/memory_card.cpp
+++ b/src/core/memory_card.cpp
@@ -1,12 +1,17 @@
 #include "memory_card.h"
+#include "YBaseLib/AutoReleasePtr.h"
+#include "YBaseLib/ByteStream.h"
+#include "YBaseLib/FileSystem.h"
 #include "YBaseLib/Log.h"
 #include "common/state_wrapper.h"
+#include "host_interface.h"
+#include "system.h"
+#include <cstdio>
 Log_SetChannel(MemoryCard);
 
-MemoryCard::MemoryCard()
+MemoryCard::MemoryCard(System* system) : m_system(system)
 {
   m_FLAG.no_write_yet = true;
-  Format();
 }
 
 MemoryCard::~MemoryCard() = default;
@@ -24,6 +29,7 @@ bool MemoryCard::DoState(StateWrapper& sw)
   sw.Do(&m_checksum);
   sw.Do(&m_last_byte);
   sw.Do(&m_data);
+  sw.Do(&m_changed);
 
   return !sw.HasError();
 }
@@ -35,6 +41,7 @@ void MemoryCard::ResetTransferState()
   m_sector_offset = 0;
   m_checksum = 0;
   m_last_byte = 0;
+  m_changed = false;
 }
 
 bool MemoryCard::Transfer(const u8 data_in, u8* data_out)
@@ -134,7 +141,12 @@ bool MemoryCard::Transfer(const u8 data_in, u8* data_out)
         m_checksum ^= data_in;
       }
 
-      m_data[ZeroExtend32(m_address) * SECTOR_SIZE + m_sector_offset] = data_in;
+      const u32 offset = ZeroExtend32(m_address) * SECTOR_SIZE + m_sector_offset;
+      if (m_data[offset] != data_in)
+        m_changed = true;
+
+      m_data[offset] = data_in;
+
       *data_out = m_last_byte;
       ack = true;
 
@@ -143,6 +155,11 @@ bool MemoryCard::Transfer(const u8 data_in, u8* data_out)
       {
         m_state = State::WriteChecksum;
         m_sector_offset = 0;
+        if (m_changed)
+        {
+          m_changed = false;
+          SaveToFile();
+        }
       }
     }
     break;
@@ -213,9 +230,24 @@ bool MemoryCard::Transfer(const u8 data_in, u8* data_out)
   return ack;
 }
 
-std::shared_ptr<MemoryCard> MemoryCard::Create()
+std::shared_ptr<MemoryCard> MemoryCard::Create(System* system)
 {
-  return std::make_shared<MemoryCard>();
+  auto mc = std::make_shared<MemoryCard>(system);
+  mc->Format();
+  return mc;
+}
+
+std::shared_ptr<MemoryCard> MemoryCard::Open(System* system, std::string_view filename)
+{
+  auto mc = std::make_shared<MemoryCard>(system);
+  mc->m_filename = filename;
+  if (!mc->LoadFromFile())
+  {
+    Log_ErrorPrintf("Memory card at '%s' could not be read, formatting.");
+    mc->Format();
+  }
+
+  return mc;
 }
 
 u8 MemoryCard::ChecksumFrame(const u8* fptr)
@@ -285,3 +317,46 @@ u8* MemoryCard::GetSectorPtr(u32 sector)
   Assert(sector < NUM_SECTORS);
   return &m_data[sector * SECTOR_SIZE];
 }
+
+bool MemoryCard::LoadFromFile()
+{
+  AutoReleasePtr<ByteStream> stream =
+    FileSystem::OpenFile(m_filename.c_str(), BYTESTREAM_OPEN_READ | BYTESTREAM_OPEN_STREAMED);
+  if (!stream)
+    return false;
+
+  const size_t num_read = stream->Read(m_data.data(), SECTOR_SIZE * NUM_SECTORS);
+  if (num_read != (SECTOR_SIZE * NUM_SECTORS))
+  {
+    Log_ErrorPrintf("Only read %zu of %u sectors from '%s'", num_read / SECTOR_SIZE, NUM_SECTORS, m_filename.c_str());
+    return false;
+  }
+
+  return true;
+}
+
+bool MemoryCard::SaveToFile()
+{
+  if (m_filename.empty())
+    return false;
+
+  AutoReleasePtr<ByteStream> stream =
+    FileSystem::OpenFile(m_filename.c_str(), BYTESTREAM_OPEN_CREATE | BYTESTREAM_OPEN_TRUNCATE | BYTESTREAM_OPEN_WRITE |
+                                               BYTESTREAM_OPEN_ATOMIC_UPDATE | BYTESTREAM_OPEN_STREAMED);
+  if (!stream)
+  {
+    Log_ErrorPrintf("Failed to open '%s' for writing.", m_filename.c_str());
+    return false;
+  }
+
+  if (!stream->Write2(m_data.data(), SECTOR_SIZE * NUM_SECTORS) || !stream->Commit())
+  {
+    Log_ErrorPrintf("Failed to write sectors to '%s'", m_filename.c_str());
+    stream->Discard();
+    return false;
+  }
+
+  Log_InfoPrintf("Saved memory card to '%s'", m_filename.c_str());
+  m_system->GetHostInterface()->AddOSDMessage(SmallString::FromFormat("Saved memory card to '%s'", m_filename.c_str()));
+  return true;
+}
\ No newline at end of file
diff --git a/src/core/memory_card.h b/src/core/memory_card.h
index 1645f76b4..9cbd0096a 100644
--- a/src/core/memory_card.h
+++ b/src/core/memory_card.h
@@ -1,8 +1,12 @@
 #pragma once
 #include "common/bitfield.h"
 #include "pad_device.h"
-#include <memory>
 #include <array>
+#include <memory>
+#include <string>
+#include <string_view>
+
+class System;
 
 class MemoryCard final : public PadDevice
 {
@@ -14,10 +18,11 @@ public:
     NUM_SECTORS = DATA_SIZE / SECTOR_SIZE
   };
 
-  MemoryCard();
+  MemoryCard(System* system);
   ~MemoryCard() override;
 
-  static std::shared_ptr<MemoryCard> Create();
+  static std::shared_ptr<MemoryCard> Create(System* system);
+  static std::shared_ptr<MemoryCard> Open(System* system, std::string_view filename);
 
   void Reset() override;
   bool DoState(StateWrapper& sw) override;
@@ -70,11 +75,19 @@ private:
 
   u8* GetSectorPtr(u32 sector);
 
+  bool LoadFromFile();
+  bool SaveToFile();
+
+  System* m_system;
+
   State m_state = State::Idle;
   u16 m_address = 0;
   u8 m_sector_offset = 0;
   u8 m_checksum = 0;
   u8 m_last_byte = 0;
+  bool m_changed = false;
 
   std::array<u8, DATA_SIZE> m_data{};
+
+  std::string m_filename;
 };
diff --git a/src/core/pad.cpp b/src/core/pad.cpp
index 30b03e651..eac92a26f 100644
--- a/src/core/pad.cpp
+++ b/src/core/pad.cpp
@@ -1,7 +1,9 @@
 #include "pad.h"
 #include "YBaseLib/Log.h"
 #include "common/state_wrapper.h"
+#include "host_interface.h"
 #include "interrupt_controller.h"
+#include "memory_card.h"
 #include "pad_device.h"
 #include "system.h"
 Log_SetChannel(Pad);
@@ -46,6 +48,28 @@ bool Pad::DoState(StateWrapper& sw)
         return false;
     }
 
+    bool card_present = static_cast<bool>(m_memory_cards[i]);
+    sw.Do(&card_present);
+
+    if (card_present && !m_memory_cards[i])
+    {
+      const TinyString message = TinyString::FromFormat(
+        "Memory card %c present in save state but not in system. Creating temporary card.", 'A' + i);
+      m_system->GetHostInterface()->AddOSDMessage(message);
+      Log_WarningPrint(message);
+
+      m_memory_cards[i] = MemoryCard::Create(m_system);
+    }
+    else if (!card_present && m_memory_cards[i])
+    {
+      const TinyString message =
+        TinyString::FromFormat("Memory card %u present system but not save state. Removing card.", 'A' + i);
+      m_system->GetHostInterface()->AddOSDMessage(message);
+      Log_WarningPrint(message);
+
+      m_memory_cards[i].reset();
+    }
+
     if (m_memory_cards[i])
     {
       if (!sw.DoMarker("MemoryCard") || !m_memory_cards[i]->DoState(sw))
diff --git a/src/core/pad.h b/src/core/pad.h
index 289442fb4..36cc0050b 100644
--- a/src/core/pad.h
+++ b/src/core/pad.h
@@ -10,6 +10,7 @@ class StateWrapper;
 class System;
 class InterruptController;
 class PadDevice;
+class MemoryCard;
 
 class Pad
 {
@@ -24,8 +25,8 @@ public:
   PadDevice* GetController(u32 slot) { return m_controllers[slot].get(); }
   void SetController(u32 slot, std::shared_ptr<PadDevice> dev) { m_controllers[slot] = dev; }
 
-  PadDevice* GetMemoryCard(u32 slot) { return m_memory_cards[slot].get(); }
-  void SetMemoryCard(u32 slot, std::shared_ptr<PadDevice> dev) { m_memory_cards[slot] = dev; }
+  MemoryCard* GetMemoryCard(u32 slot) { return m_memory_cards[slot].get(); }
+  void SetMemoryCard(u32 slot, std::shared_ptr<MemoryCard> dev) { m_memory_cards[slot] = dev; }
 
   u32 ReadRegister(u32 offset);
   void WriteRegister(u32 offset, u32 value);
@@ -118,5 +119,5 @@ private:
   InlineFIFOQueue<u8, 2> m_TX_FIFO;
 
   std::array<std::shared_ptr<PadDevice>, NUM_SLOTS> m_controllers;
-  std::array<std::shared_ptr<PadDevice>, NUM_SLOTS> m_memory_cards;
+  std::array<std::shared_ptr<MemoryCard>, NUM_SLOTS> m_memory_cards;
 };
diff --git a/src/core/settings.h b/src/core/settings.h
index baab818f7..455d7e678 100644
--- a/src/core/settings.h
+++ b/src/core/settings.h
@@ -32,4 +32,7 @@ struct Settings
   } debugging;
 
   // TODO: Controllers, memory cards, etc.
+
+  std::string memory_card_a_filename;
+  std::string memory_card_b_filename;
 };
diff --git a/src/core/system.cpp b/src/core/system.cpp
index c66b6608d..f38851019 100644
--- a/src/core/system.cpp
+++ b/src/core/system.cpp
@@ -9,6 +9,7 @@
 #include "gpu.h"
 #include "interrupt_controller.h"
 #include "mdec.h"
+#include "memory_card.h"
 #include "pad.h"
 #include "pad_device.h"
 #include "spu.h"
@@ -98,6 +99,8 @@ bool System::Initialize()
   if (!m_mdec->Initialize(this, m_dma.get()))
     return false;
 
+  UpdateMemoryCards();
+
   return true;
 }
 
@@ -361,9 +364,24 @@ void System::SetController(u32 slot, std::shared_ptr<PadDevice> dev)
   m_pad->SetController(slot, std::move(dev));
 }
 
-void System::SetMemoryCard(u32 slot, std::shared_ptr<PadDevice> dev)
+void System::UpdateMemoryCards()
 {
-  m_pad->SetMemoryCard(slot, std::move(dev));
+  m_pad->SetMemoryCard(0, nullptr);
+  m_pad->SetMemoryCard(1, nullptr);
+
+  if (!m_settings.memory_card_a_filename.empty())
+  {
+    std::shared_ptr<MemoryCard> card = MemoryCard::Open(this, m_settings.memory_card_a_filename);
+    if (card)
+      m_pad->SetMemoryCard(0, std::move(card));
+  }
+
+  if (!m_settings.memory_card_b_filename.empty())
+  {
+    std::shared_ptr<MemoryCard> card = MemoryCard::Open(this, m_settings.memory_card_b_filename);
+    if (card)
+      m_pad->SetMemoryCard(1, std::move(card));
+  }
 }
 
 bool System::HasMedia() const
diff --git a/src/core/system.h b/src/core/system.h
index 24df00672..39b2fc5d4 100644
--- a/src/core/system.h
+++ b/src/core/system.h
@@ -71,7 +71,7 @@ public:
   void StallCPU(TickCount ticks);
 
   void SetController(u32 slot, std::shared_ptr<PadDevice> dev);
-  void SetMemoryCard(u32 slot, std::shared_ptr<PadDevice> dev);
+  void UpdateMemoryCards();
 
   bool HasMedia() const;
   bool InsertMedia(const char* path);
diff --git a/src/duckstation/sdl_interface.cpp b/src/duckstation/sdl_interface.cpp
index da7010381..c7294c6ea 100644
--- a/src/duckstation/sdl_interface.cpp
+++ b/src/duckstation/sdl_interface.cpp
@@ -271,9 +271,6 @@ void SDLInterface::ConnectDevices()
 {
   m_controller = DigitalController::Create();
   m_system->SetController(0, m_controller);
-
-  m_memory_card = MemoryCard::Create();
-  m_system->SetMemoryCard(0, m_memory_card);
 }
 
 std::unique_ptr<SDLInterface> SDLInterface::Create(const char* filename /* = nullptr */,
diff --git a/src/duckstation/sdl_interface.h b/src/duckstation/sdl_interface.h
index f20738816..0d644eeed 100644
--- a/src/duckstation/sdl_interface.h
+++ b/src/duckstation/sdl_interface.h
@@ -111,7 +111,6 @@ private:
   std::map<int, SDL_GameController*> m_sdl_controllers;
 
   std::shared_ptr<DigitalController> m_controller;
-  std::shared_ptr<MemoryCard> m_memory_card;
 
   float m_vps = 0.0f;
   float m_fps = 0.0f;