diff --git a/src/duckstation-qt/CMakeLists.txt b/src/duckstation-qt/CMakeLists.txt
index 1c4306172..bb44f73ef 100644
--- a/src/duckstation-qt/CMakeLists.txt
+++ b/src/duckstation-qt/CMakeLists.txt
@@ -179,7 +179,10 @@ target_compile_definitions(duckstation-qt PRIVATE QT_NO_EXCEPTIONS)
 add_core_resources(duckstation-qt)
 
 if(WIN32)
-  target_sources(duckstation-qt PRIVATE duckstation-qt.rc)
+  target_sources(duckstation-qt PRIVATE
+    duckstation-qt.rc
+    vcruntimecheck.cpp
+  )
 
   # We want a Windows subsystem application not console.
   set_target_properties(duckstation-qt PROPERTIES
diff --git a/src/duckstation-qt/duckstation-qt.vcxproj b/src/duckstation-qt/duckstation-qt.vcxproj
index 07e34f8ee..1696c6390 100644
--- a/src/duckstation-qt/duckstation-qt.vcxproj
+++ b/src/duckstation-qt/duckstation-qt.vcxproj
@@ -51,6 +51,7 @@
     <ClCompile Include="selectdiscdialog.cpp" />
     <ClCompile Include="settingswindow.cpp" />
     <ClCompile Include="setupwizarddialog.cpp" />
+    <ClCompile Include="vcruntimecheck.cpp" />
   </ItemGroup>
   <ItemGroup>
     <QtMoc Include="setupwizarddialog.h" />
diff --git a/src/duckstation-qt/duckstation-qt.vcxproj.filters b/src/duckstation-qt/duckstation-qt.vcxproj.filters
index 25961d409..cfe5d458f 100644
--- a/src/duckstation-qt/duckstation-qt.vcxproj.filters
+++ b/src/duckstation-qt/duckstation-qt.vcxproj.filters
@@ -178,6 +178,7 @@
     <ClCompile Include="$(IntDir)moc_selectdiscdialog.cpp">
       <Filter>moc</Filter>
     </ClCompile>
+    <ClCompile Include="vcruntimecheck.cpp" />
   </ItemGroup>
   <ItemGroup>
     <ClInclude Include="qtutils.h" />
diff --git a/src/duckstation-qt/vcruntimecheck.cpp b/src/duckstation-qt/vcruntimecheck.cpp
new file mode 100644
index 000000000..dc892c17b
--- /dev/null
+++ b/src/duckstation-qt/vcruntimecheck.cpp
@@ -0,0 +1,108 @@
+// SPDX-FileCopyrightText: 2019-2024 Connor McLaughlin <stenzek@gmail.com>
+// SPDX-License-Identifier: (GPL-3.0 OR CC-BY-NC-ND-4.0)
+
+#include "common/windows_headers.h"
+#include <shellapi.h>
+
+#include "fmt/format.h"
+
+// Minimum version is 14.38.33135.0.
+static constexpr u32 MIN_VERSION_V0 = 14;
+static constexpr u32 MIN_VERSION_V1 = 38;
+static constexpr u32 MIN_VERSION_V2 = 33135;
+static constexpr u32 MIN_VERSION_V3 = 0;
+static constexpr const char* DOWNLOAD_URL = "https://aka.ms/vs/17/release/vc_redist.x64.exe";
+
+struct VCRuntimeCheckObject
+{
+  VCRuntimeCheckObject()
+  {
+    const HMODULE crt_handle = GetModuleHandleW(L"msvcp140.dll");
+    if (!crt_handle)
+      return;
+
+    const HANDLE heap = GetProcessHeap();
+    DWORD filename_length = MAX_PATH;
+    LPWSTR filename = static_cast<LPWSTR>(HeapAlloc(heap, 0, filename_length));
+    if (!filename)
+      return;
+
+    for (;;)
+    {
+      DWORD len = GetModuleFileNameW(crt_handle, filename, filename_length);
+      if (len == filename_length && GetLastError() == ERROR_INSUFFICIENT_BUFFER)
+      {
+        filename_length *= 2;
+        if (filename_length >= 4 * 1024)
+          return;
+        LPWSTR new_filename = static_cast<LPWSTR>(HeapReAlloc(heap, 0, filename, filename_length));
+        if (!new_filename)
+        {
+          HeapFree(heap, 0, filename);
+          return;
+        }
+        filename = new_filename;
+        continue;
+      }
+
+      break;
+    }
+
+    const DWORD version_size = GetFileVersionInfoSizeExW(0, filename, nullptr);
+    LPVOID version_block;
+    if (version_size == 0 || !(version_block = HeapAlloc(heap, 0, version_size)))
+    {
+      HeapFree(heap, 0, filename);
+      return;
+    }
+
+    VS_FIXEDFILEINFO* fi;
+    UINT fi_size;
+    if (!GetFileVersionInfoExW(0, filename, 0, version_size, version_block) ||
+        !VerQueryValueW(version_block, L"\\", reinterpret_cast<LPVOID*>(&fi), &fi_size))
+    {
+      HeapFree(heap, 0, version_block);
+      HeapFree(heap, 0, filename);
+      return;
+    }
+
+    const DWORD v0 = (fi->dwFileVersionMS >> 16) & 0xFFFFu;
+    const DWORD v1 = fi->dwFileVersionMS & 0xFFFFu;
+    const DWORD v2 = (fi->dwFileVersionLS >> 16) & 0xFFFFu;
+    const DWORD v3 = fi->dwFileVersionLS & 0xFFFFu;
+
+    HeapFree(heap, 0, version_block);
+    HeapFree(heap, 0, filename);
+
+    if (v0 >= MIN_VERSION_V0 && v1 >= MIN_VERSION_V1 && v2 >= MIN_VERSION_V2)
+      return;
+
+    // fmt is self-contained, hopefully it'll be okay.
+    char message[512];
+    const auto fmt_result =
+      fmt::format_to_n(message, sizeof(message),
+                       "Your Microsoft Visual C++ Runtime appears to be too old for this build of DuckStation.\n\n"
+                       "Your version: {}.{}.{}.{}\n"
+                       "Required version: {}.{}.{}.{}\n\n"
+                       "You can download the latest version from {}.\n\n"
+                       "Do you want to exit and download this version now?\n"
+                       "If you select No, DuckStation will likely crash.",
+                       v0, v1, v2, v3, MIN_VERSION_V0, MIN_VERSION_V1, MIN_VERSION_V2, MIN_VERSION_V3, DOWNLOAD_URL);
+    message[(fmt_result.size > (sizeof(message) - 1)) ? (sizeof(message) - 1) : fmt_result.size] = 0;
+
+    if (MessageBoxA(NULL, message, "Old Visual C++ Runtime Detected", MB_ICONERROR | MB_YESNO) == IDNO)
+      return;
+
+    if (!ShellExecuteA(NULL, "open", DOWNLOAD_URL, nullptr, nullptr, SW_SHOWNORMAL))
+      MessageBoxA(NULL, "ShellExecuteA() failed, you may need to manually open the URL.", "Error", MB_OK);
+
+    TerminateProcess(GetCurrentProcess(), 0xFFFFFFFF);
+  }
+};
+
+// We have to use a special object which gets initialized before all other global objects, because those might use the
+// CRT and go kaboom. Yucky, but gets the job done.
+#pragma optimize("", off)
+#pragma warning(disable : 4075) // warning C4075: initializers put in unrecognized initialization area
+#pragma init_seg(".CRT$XCT")
+VCRuntimeCheckObject s_vcruntime_checker;