diff --git a/src/core/gpu_hw.cpp b/src/core/gpu_hw.cpp
index 217ac4615..1750e291f 100644
--- a/src/core/gpu_hw.cpp
+++ b/src/core/gpu_hw.cpp
@@ -26,9 +26,11 @@ bool GPU_HW::Initialize(HostDisplay* host_display, System* system, DMA* dma, Int
   if (!GPU::Initialize(host_display, system, dma, interrupt_controller, timers))
     return false;
 
-  m_resolution_scale = m_system->GetSettings().gpu_resolution_scale;
-  m_true_color = m_system->GetSettings().gpu_true_color;
-  m_texture_filtering = m_system->GetSettings().gpu_texture_filtering;
+  const Settings& settings = m_system->GetSettings();
+  m_resolution_scale = settings.gpu_resolution_scale;
+  m_true_color = settings.gpu_true_color;
+  m_scaled_dithering = settings.gpu_scaled_dithering;
+  m_texture_filtering = settings.gpu_texture_filtering;
   if (m_resolution_scale < 1 || m_resolution_scale > m_max_resolution_scale)
   {
     m_system->GetHostInterface()->AddFormattedOSDMessage(5.0f, "Invalid resolution scale %ux specified. Maximum is %u.",
@@ -68,9 +70,11 @@ void GPU_HW::UpdateSettings()
 {
   GPU::UpdateSettings();
 
-  m_resolution_scale = std::clamp<u32>(m_system->GetSettings().gpu_resolution_scale, 1, m_max_resolution_scale);
-  m_true_color = m_system->GetSettings().gpu_true_color;
-  m_texture_filtering = m_system->GetSettings().gpu_texture_filtering;
+  const Settings& settings = m_system->GetSettings();
+  m_resolution_scale = std::clamp<u32>(settings.gpu_resolution_scale, 1, m_max_resolution_scale);
+  m_true_color = settings.gpu_true_color;
+  m_scaled_dithering = settings.gpu_scaled_dithering;
+  m_texture_filtering = settings.gpu_texture_filtering;
 }
 
 void GPU_HW::LoadVertices(RenderCommand rc, u32 num_vertices, const u32* command_ptr)
diff --git a/src/core/gpu_hw.h b/src/core/gpu_hw.h
index 1f3baebf5..48c857d65 100644
--- a/src/core/gpu_hw.h
+++ b/src/core/gpu_hw.h
@@ -161,7 +161,8 @@ protected:
 
   u32 m_resolution_scale = 1;
   u32 m_max_resolution_scale = 1;
-  bool m_true_color = false;
+  bool m_true_color = true;
+  bool m_scaled_dithering = false;
   bool m_texture_filtering = false;
   bool m_supports_dual_source_blend = false;
 
diff --git a/src/core/gpu_hw_d3d11.cpp b/src/core/gpu_hw_d3d11.cpp
index 80a7b8e36..fbea38a2f 100644
--- a/src/core/gpu_hw_d3d11.cpp
+++ b/src/core/gpu_hw_d3d11.cpp
@@ -242,8 +242,8 @@ bool GPU_HW_D3D11::CreateBatchInputLayout()
      {"ATTR", 3, DXGI_FORMAT_R32_SINT, 0, offsetof(BatchVertex, texpage), D3D11_INPUT_PER_VERTEX_DATA, 0}}};
 
   // we need a vertex shader...
-  GPU_HW_ShaderGen shadergen(m_host_display->GetRenderAPI(), m_resolution_scale, m_true_color, m_texture_filtering,
-                             m_supports_dual_source_blend);
+  GPU_HW_ShaderGen shadergen(m_host_display->GetRenderAPI(), m_resolution_scale, m_true_color, m_scaled_dithering,
+                             m_texture_filtering, m_supports_dual_source_blend);
   ComPtr<ID3DBlob> vs_bytecode =
     m_shader_cache.GetShaderBlob(D3D11::ShaderCompiler::Type::Vertex, shadergen.GenerateBatchVertexShader(true));
   if (!vs_bytecode)
@@ -325,8 +325,8 @@ bool GPU_HW_D3D11::CreateStateObjects()
 
 bool GPU_HW_D3D11::CompileShaders()
 {
-  GPU_HW_ShaderGen shadergen(m_host_display->GetRenderAPI(), m_resolution_scale, m_true_color, m_texture_filtering,
-                             m_supports_dual_source_blend);
+  GPU_HW_ShaderGen shadergen(m_host_display->GetRenderAPI(), m_resolution_scale, m_true_color, m_scaled_dithering,
+                             m_texture_filtering, m_supports_dual_source_blend);
 
   m_system->GetHostInterface()->DisplayLoadingScreen("Compiling shaders...");
 
diff --git a/src/core/gpu_hw_opengl.cpp b/src/core/gpu_hw_opengl.cpp
index 4c4cc3d9c..f5d2ce6f9 100644
--- a/src/core/gpu_hw_opengl.cpp
+++ b/src/core/gpu_hw_opengl.cpp
@@ -290,8 +290,8 @@ bool GPU_HW_OpenGL::CreateTextureBuffer()
 
 bool GPU_HW_OpenGL::CompilePrograms()
 {
-  GPU_HW_ShaderGen shadergen(m_host_display->GetRenderAPI(), m_resolution_scale, m_true_color, m_texture_filtering,
-                             m_supports_dual_source_blend);
+  GPU_HW_ShaderGen shadergen(m_host_display->GetRenderAPI(), m_resolution_scale, m_true_color, m_scaled_dithering,
+                             m_texture_filtering, m_supports_dual_source_blend);
 
   m_system->GetHostInterface()->DisplayLoadingScreen("Compiling Shaders...");
 
diff --git a/src/core/gpu_hw_opengl_es.cpp b/src/core/gpu_hw_opengl_es.cpp
index 2ae57b8fd..207cff22c 100644
--- a/src/core/gpu_hw_opengl_es.cpp
+++ b/src/core/gpu_hw_opengl_es.cpp
@@ -188,8 +188,8 @@ void GPU_HW_OpenGL_ES::ClearFramebuffer()
 
 bool GPU_HW_OpenGL_ES::CompilePrograms()
 {
-  GPU_HW_ShaderGen shadergen(m_host_display->GetRenderAPI(), m_resolution_scale, m_true_color, m_texture_filtering,
-                             m_supports_dual_source_blend);
+  GPU_HW_ShaderGen shadergen(m_host_display->GetRenderAPI(), m_resolution_scale, m_true_color, m_scaled_dithering,
+                             m_texture_filtering, m_supports_dual_source_blend);
 
   for (u32 render_mode = 0; render_mode < 4; render_mode++)
   {
diff --git a/src/core/gpu_hw_shadergen.cpp b/src/core/gpu_hw_shadergen.cpp
index b48868a38..1434772eb 100644
--- a/src/core/gpu_hw_shadergen.cpp
+++ b/src/core/gpu_hw_shadergen.cpp
@@ -6,10 +6,11 @@
 Log_SetChannel(GPU_HW_ShaderGen);
 
 GPU_HW_ShaderGen::GPU_HW_ShaderGen(HostDisplay::RenderAPI render_api, u32 resolution_scale, bool true_color,
-                                   bool texture_filtering, bool supports_dual_source_blend)
+                                   bool scaled_dithering, bool texture_filtering, bool supports_dual_source_blend)
   : m_render_api(render_api), m_resolution_scale(resolution_scale), m_true_color(true_color),
-    m_texture_filering(texture_filtering), m_glsl(render_api != HostDisplay::RenderAPI::D3D11),
-    m_glsl_es(render_api == HostDisplay::RenderAPI::OpenGLES), m_supports_dual_source_blend(supports_dual_source_blend)
+    m_scaled_dithering(scaled_dithering), m_texture_filering(texture_filtering),
+    m_glsl(render_api != HostDisplay::RenderAPI::D3D11), m_glsl_es(render_api == HostDisplay::RenderAPI::OpenGLES),
+    m_supports_dual_source_blend(supports_dual_source_blend)
 {
   if (m_glsl)
     SetGLSLVersionString();
@@ -411,6 +412,7 @@ std::string GPU_HW_ShaderGen::GenerateBatchFragmentShader(GPU_HW::BatchRenderMod
   DefineMacro(ss, "PALETTE_8_BIT", actual_texture_mode == GPU::TextureMode::Palette8Bit);
   DefineMacro(ss, "RAW_TEXTURE", raw_texture);
   DefineMacro(ss, "DITHERING", dithering);
+  DefineMacro(ss, "DITHERING_SCALED", m_scaled_dithering);
   DefineMacro(ss, "TRUE_COLOR", m_true_color);
   DefineMacro(ss, "TEXTURE_FILTERING", m_texture_filering);
   DefineMacro(ss, "USE_DUAL_SOURCE", use_dual_source);
@@ -570,7 +572,11 @@ float4 SampleFromVRAM(int4 texpage, int2 icoord)
 
   // Apply dithering
   #if DITHERING
-    icolor = ApplyDithering(int2(v_pos.xy) / int2(RESOLUTION_SCALE, RESOLUTION_SCALE), icolor);
+    #if DITHERING_SCALED
+      icolor = ApplyDithering(int2(v_pos.xy), icolor);
+    #else
+      icolor = ApplyDithering(int2(v_pos.xy) / int2(RESOLUTION_SCALE, RESOLUTION_SCALE), icolor);
+    #endif
   #endif
 
   // Clip to 15-bit range
diff --git a/src/core/gpu_hw_shadergen.h b/src/core/gpu_hw_shadergen.h
index b7c1a7cfa..a4d788e63 100644
--- a/src/core/gpu_hw_shadergen.h
+++ b/src/core/gpu_hw_shadergen.h
@@ -7,7 +7,7 @@
 class GPU_HW_ShaderGen
 {
 public:
-  GPU_HW_ShaderGen(HostDisplay::RenderAPI render_api, u32 resolution_scale, bool true_color,
+  GPU_HW_ShaderGen(HostDisplay::RenderAPI render_api, u32 resolution_scale, bool true_color, bool scaled_dithering,
                    bool texture_filtering, bool supports_dual_source_belnd);
   ~GPU_HW_ShaderGen();
 
@@ -25,6 +25,7 @@ public:
   HostDisplay::RenderAPI m_render_api;
   u32 m_resolution_scale;
   bool m_true_color;
+  bool m_scaled_dithering;
   bool m_texture_filering;
   bool m_glsl;
   bool m_glsl_es;
diff --git a/src/core/host_interface.cpp b/src/core/host_interface.cpp
index e2712ae22..b0f0aaa02 100644
--- a/src/core/host_interface.cpp
+++ b/src/core/host_interface.cpp
@@ -812,6 +812,7 @@ void HostInterface::SetDefaultSettings(SettingsInterface& si)
   si.SetStringValue("GPU", "Renderer", Settings::GetRendererName(Settings::DEFAULT_GPU_RENDERER));
   si.SetIntValue("GPU", "ResolutionScale", 1);
   si.SetBoolValue("GPU", "TrueColor", true);
+  si.SetBoolValue("GPU", "ScaledDithering", false);
   si.SetBoolValue("GPU", "TextureFiltering", false);
   si.SetBoolValue("GPU", "UseDebugDevice", false);
 
@@ -855,6 +856,7 @@ void HostInterface::UpdateSettings(const std::function<void()>& apply_callback)
   const GPURenderer old_gpu_renderer = m_settings.gpu_renderer;
   const u32 old_gpu_resolution_scale = m_settings.gpu_resolution_scale;
   const bool old_gpu_true_color = m_settings.gpu_true_color;
+  const bool old_gpu_scaled_dithering = m_settings.gpu_scaled_dithering;
   const bool old_gpu_texture_filtering = m_settings.gpu_texture_filtering;
   const bool old_display_force_progressive_scan = m_settings.display_force_progressive_scan;
   const bool old_gpu_debug_device = m_settings.gpu_use_debug_device;
@@ -907,6 +909,7 @@ void HostInterface::UpdateSettings(const std::function<void()>& apply_callback)
 
     if (m_settings.gpu_resolution_scale != old_gpu_resolution_scale ||
         m_settings.gpu_true_color != old_gpu_true_color ||
+        m_settings.gpu_scaled_dithering != old_gpu_scaled_dithering ||
         m_settings.gpu_texture_filtering != old_gpu_texture_filtering ||
         m_settings.display_force_progressive_scan != old_display_force_progressive_scan ||
         m_settings.display_crop_mode != old_display_crop_mode)
diff --git a/src/core/settings.cpp b/src/core/settings.cpp
index dcdb10d47..2c570c49f 100644
--- a/src/core/settings.cpp
+++ b/src/core/settings.cpp
@@ -22,7 +22,8 @@ void Settings::Load(SettingsInterface& si)
   gpu_renderer = ParseRendererName(si.GetStringValue("GPU", "Renderer", GetRendererName(DEFAULT_GPU_RENDERER)).c_str())
                    .value_or(DEFAULT_GPU_RENDERER);
   gpu_resolution_scale = static_cast<u32>(si.GetIntValue("GPU", "ResolutionScale", 1));
-  gpu_true_color = si.GetBoolValue("GPU", "TrueColor", false);
+  gpu_true_color = si.GetBoolValue("GPU", "TrueColor", true);
+  gpu_scaled_dithering = si.GetBoolValue("GPU", "ScaledDithering", false);
   gpu_texture_filtering = si.GetBoolValue("GPU", "TextureFiltering", false);
   gpu_use_debug_device = si.GetBoolValue("GPU", "UseDebugDevice", false);
 
@@ -78,6 +79,7 @@ void Settings::Save(SettingsInterface& si) const
   si.SetStringValue("GPU", "Renderer", GetRendererName(gpu_renderer));
   si.SetIntValue("GPU", "ResolutionScale", static_cast<long>(gpu_resolution_scale));
   si.SetBoolValue("GPU", "TrueColor", gpu_true_color);
+  si.SetBoolValue("GPU", "ScaledDithering", gpu_scaled_dithering);
   si.SetBoolValue("GPU", "TextureFiltering", gpu_texture_filtering);
   si.SetBoolValue("GPU", "UseDebugDevice", gpu_use_debug_device);
 
diff --git a/src/core/settings.h b/src/core/settings.h
index 344817cca..62b7358e1 100644
--- a/src/core/settings.h
+++ b/src/core/settings.h
@@ -46,7 +46,8 @@ struct Settings
 
   GPURenderer gpu_renderer = GPURenderer::Software;
   u32 gpu_resolution_scale = 1;
-  bool gpu_true_color = false;
+  bool gpu_true_color = true;
+  bool gpu_scaled_dithering = false;
   bool gpu_texture_filtering = false;
   bool gpu_use_debug_device = false;
   DisplayCropMode display_crop_mode = DisplayCropMode::None;
diff --git a/src/duckstation-qt/gpusettingswidget.cpp b/src/duckstation-qt/gpusettingswidget.cpp
index f1c2d14c6..c97def9bc 100644
--- a/src/duckstation-qt/gpusettingswidget.cpp
+++ b/src/duckstation-qt/gpusettingswidget.cpp
@@ -22,11 +22,25 @@ GPUSettingsWidget::GPUSettingsWidget(QtHostInterface* host_interface, QWidget* p
   SettingWidgetBinder::BindWidgetToBoolSetting(m_host_interface, m_ui.vsync, "Display/VSync");
   SettingWidgetBinder::BindWidgetToIntSetting(m_host_interface, m_ui.resolutionScale, "GPU/ResolutionScale");
   SettingWidgetBinder::BindWidgetToBoolSetting(m_host_interface, m_ui.trueColor, "GPU/TrueColor");
+  SettingWidgetBinder::BindWidgetToBoolSetting(m_host_interface, m_ui.scaledDithering, "GPU/ScaledDithering");
   SettingWidgetBinder::BindWidgetToBoolSetting(m_host_interface, m_ui.linearTextureFiltering, "GPU/TextureFiltering");
+
+  connect(m_ui.resolutionScale, static_cast<void (QComboBox::*)(int)>(&QComboBox::currentIndexChanged), this,
+          &GPUSettingsWidget::updateScaledDitheringEnabled);
+  connect(m_ui.trueColor, &QCheckBox::stateChanged, this, &GPUSettingsWidget::updateScaledDitheringEnabled);
+  updateScaledDitheringEnabled();
 }
 
 GPUSettingsWidget::~GPUSettingsWidget() = default;
 
+void GPUSettingsWidget::updateScaledDitheringEnabled()
+{
+  const int resolution_scale = m_ui.resolutionScale->currentIndex();
+  const bool true_color = m_ui.trueColor->isChecked();
+  const bool allow_scaled_dithering = (resolution_scale != 1 && !true_color);
+  m_ui.scaledDithering->setEnabled(allow_scaled_dithering);
+}
+
 void GPUSettingsWidget::setupAdditionalUi()
 {
   for (u32 i = 0; i < static_cast<u32>(GPURenderer::Count); i++)
diff --git a/src/duckstation-qt/gpusettingswidget.h b/src/duckstation-qt/gpusettingswidget.h
index 5847de7fc..89e8f1e30 100644
--- a/src/duckstation-qt/gpusettingswidget.h
+++ b/src/duckstation-qt/gpusettingswidget.h
@@ -14,6 +14,9 @@ public:
   GPUSettingsWidget(QtHostInterface* host_interface, QWidget* parent = nullptr);
   ~GPUSettingsWidget();
 
+private Q_SLOTS:
+  void updateScaledDitheringEnabled();
+
 private:
   void setupAdditionalUi();
 
diff --git a/src/duckstation-qt/gpusettingswidget.ui b/src/duckstation-qt/gpusettingswidget.ui
index d60426e07..8273db9ab 100644
--- a/src/duckstation-qt/gpusettingswidget.ui
+++ b/src/duckstation-qt/gpusettingswidget.ui
@@ -123,6 +123,13 @@
        </widget>
       </item>
       <item row="2" column="0" colspan="2">
+       <widget class="QCheckBox" name="scaledDithering">
+        <property name="text">
+         <string>Scaled Dithering (scale dither pattern to resolution)</string>
+        </property>
+       </widget>
+      </item>
+      <item row="3" column="0" colspan="2">
        <widget class="QCheckBox" name="linearTextureFiltering">
         <property name="text">
          <string>Bilinear Texture Filtering</string>
diff --git a/src/duckstation-sdl/sdl_host_interface.cpp b/src/duckstation-sdl/sdl_host_interface.cpp
index 3c09a423a..1fde71b3a 100644
--- a/src/duckstation-sdl/sdl_host_interface.cpp
+++ b/src/duckstation-sdl/sdl_host_interface.cpp
@@ -885,6 +885,7 @@ void SDLHostInterface::DrawQuickSettingsMenu()
   }
 
   settings_changed |= ImGui::MenuItem("True (24-Bit) Color", nullptr, &m_settings_copy.gpu_true_color);
+  settings_changed |= ImGui::MenuItem("Scaled Dithering", nullptr, &m_settings_copy.gpu_scaled_dithering);
   settings_changed |= ImGui::MenuItem("Texture Filtering", nullptr, &m_settings_copy.gpu_texture_filtering);
   settings_changed |= ImGui::MenuItem("Display Linear Filtering", nullptr, &m_settings_copy.display_linear_filtering);