diff --git a/src/core/host_interface.cpp b/src/core/host_interface.cpp
index 9c01df79e..5afdbb72c 100644
--- a/src/core/host_interface.cpp
+++ b/src/core/host_interface.cpp
@@ -750,8 +750,9 @@ void HostInterface::SetDefaultSettings()
 
   m_settings.emulation_speed = 1.0f;
   m_settings.speed_limiter_enabled = true;
-  m_settings.start_paused = false;
   m_settings.increase_timer_resolution = true;
+  m_settings.start_paused = false;
+  m_settings.save_state_on_exit = true;
 
   m_settings.gpu_renderer = Settings::DEFAULT_GPU_RENDERER;
   m_settings.gpu_resolution_scale = 1;
diff --git a/src/core/settings.cpp b/src/core/settings.cpp
index 5822ef651..6c7244cbc 100644
--- a/src/core/settings.cpp
+++ b/src/core/settings.cpp
@@ -13,6 +13,7 @@ void Settings::Load(SettingsInterface& si)
   speed_limiter_enabled = si.GetBoolValue("General", "SpeedLimiterEnabled", true);
   increase_timer_resolution = si.GetBoolValue("General", "IncreaseTimerResolution", true);
   start_paused = si.GetBoolValue("General", "StartPaused", false);
+  save_state_on_exit = si.GetBoolValue("General", "SaveStateOnExit", true);
 
   cpu_execution_mode = ParseCPUExecutionMode(si.GetStringValue("CPU", "ExecutionMode", "Interpreter").c_str())
                          .value_or(CPUExecutionMode::Interpreter);
@@ -63,6 +64,7 @@ void Settings::Save(SettingsInterface& si) const
   si.SetBoolValue("General", "SpeedLimiterEnabled", speed_limiter_enabled);
   si.SetBoolValue("General", "IncreaseTimerResolution", increase_timer_resolution);
   si.SetBoolValue("General", "StartPaused", start_paused);
+  si.SetBoolValue("General", "SaveStateOnExit", save_state_on_exit);
 
   si.SetStringValue("CPU", "ExecutionMode", GetCPUExecutionModeName(cpu_execution_mode));
 
diff --git a/src/core/settings.h b/src/core/settings.h
index 2f0d12616..4e0ac5147 100644
--- a/src/core/settings.h
+++ b/src/core/settings.h
@@ -36,9 +36,10 @@ struct Settings
   CPUExecutionMode cpu_execution_mode = CPUExecutionMode::Interpreter;
 
   float emulation_speed = 1.0f;
-  bool start_paused = false;
   bool speed_limiter_enabled = true;
   bool increase_timer_resolution = true;
+  bool start_paused = false;
+  bool save_state_on_exit = true;
 
   GPURenderer gpu_renderer = GPURenderer::Software;
   u32 gpu_resolution_scale = 1;
diff --git a/src/duckstation-qt/consolesettingswidget.cpp b/src/duckstation-qt/consolesettingswidget.cpp
index eb7a2b98b..6810f7216 100644
--- a/src/duckstation-qt/consolesettingswidget.cpp
+++ b/src/duckstation-qt/consolesettingswidget.cpp
@@ -25,6 +25,7 @@ ConsoleSettingsWidget::ConsoleSettingsWidget(QtHostInterface* host_interface, QW
   SettingWidgetBinder::BindWidgetToNormalizedSetting(m_host_interface, m_ui.emulationSpeed, "General/EmulationSpeed",
                                                      100.0f);
   SettingWidgetBinder::BindWidgetToBoolSetting(m_host_interface, m_ui.pauseOnStart, "General/StartPaused");
+  SettingWidgetBinder::BindWidgetToBoolSetting(m_host_interface, m_ui.saveStateOnExit, "General/SaveStateOnExit");
   SettingWidgetBinder::BindWidgetToEnumSetting(m_host_interface, m_ui.cpuExecutionMode, "CPU/ExecutionMode",
                                                &Settings::ParseCPUExecutionMode, &Settings::GetCPUExecutionModeName);
 
diff --git a/src/duckstation-qt/consolesettingswidget.ui b/src/duckstation-qt/consolesettingswidget.ui
index dd02d7a7e..cf2708cd3 100644
--- a/src/duckstation-qt/consolesettingswidget.ui
+++ b/src/duckstation-qt/consolesettingswidget.ui
@@ -146,6 +146,13 @@
         </property>
        </widget>
       </item>
+      <item row="6" column="0" colspan="2">
+       <widget class="QCheckBox" name="saveStateOnExit">
+        <property name="text">
+         <string>Save State On Exit</string>
+        </property>
+       </widget>
+      </item>
      </layout>
     </widget>
    </item>
diff --git a/src/duckstation-qt/mainwindow.cpp b/src/duckstation-qt/mainwindow.cpp
index ac90a8a83..21deb9253 100644
--- a/src/duckstation-qt/mainwindow.cpp
+++ b/src/duckstation-qt/mainwindow.cpp
@@ -298,7 +298,7 @@ void MainWindow::connectSignals()
           &MainWindow::onChangeDiscFromGameListActionTriggered);
   connect(m_ui.actionAddGameDirectory, &QAction::triggered,
           [this]() { getSettingsDialog()->getGameListSettingsWidget()->addSearchDirectory(this); });
-  connect(m_ui.actionPowerOff, &QAction::triggered, [this]() { m_host_interface->destroySystem(true, false); });
+  connect(m_ui.actionPowerOff, &QAction::triggered, m_host_interface, &QtHostInterface::powerOffSystem);
   connect(m_ui.actionReset, &QAction::triggered, m_host_interface, &QtHostInterface::resetSystem);
   connect(m_ui.actionPause, &QAction::toggled, m_host_interface, &QtHostInterface::pauseSystem);
   connect(m_ui.actionLoadState, &QAction::triggered, this, [this]() { m_ui.menuLoadState->exec(QCursor::pos()); });
@@ -340,7 +340,10 @@ void MainWindow::connectSignals()
     QString path = QString::fromStdString(entry->path);
     if (!m_emulation_running)
     {
-      m_host_interface->bootSystemFromFile(path);
+      if (m_host_interface->getSettingValue("General/SaveStateOnExit", true).toBool())
+        m_host_interface->resumeSystemFromState(path, true);
+      else
+        m_host_interface->bootSystemFromFile(path);
     }
     else
     {
@@ -433,6 +436,6 @@ void MainWindow::updateDebugMenuGPURenderer()
 
 void MainWindow::closeEvent(QCloseEvent* event)
 {
-  m_host_interface->destroySystem(true, true);
+  m_host_interface->synchronousPowerOffSystem();
   QMainWindow::closeEvent(event);
 }
diff --git a/src/duckstation-qt/qthostinterface.cpp b/src/duckstation-qt/qthostinterface.cpp
index 9e2facf97..c7f0702b1 100644
--- a/src/duckstation-qt/qthostinterface.cpp
+++ b/src/duckstation-qt/qthostinterface.cpp
@@ -76,10 +76,10 @@ void QtHostInterface::setDefaultSettings()
   updateQSettingsFromCoreSettings();
 }
 
-QVariant QtHostInterface::getSettingValue(const QString& name)
+QVariant QtHostInterface::getSettingValue(const QString& name, const QVariant& default_value)
 {
   std::lock_guard<std::mutex> guard(m_qsettings_mutex);
-  return m_qsettings.value(name);
+  return m_qsettings.value(name, default_value);
 }
 
 void QtHostInterface::putSettingValue(const QString& name, const QVariant& value)
@@ -178,6 +178,21 @@ void QtHostInterface::bootSystemFromFile(const QString& filename)
   HostInterface::BootSystemFromFile(filename.toStdString().c_str());
 }
 
+void QtHostInterface::resumeSystemFromState(const QString& filename, bool boot_on_failure)
+{
+  if (!isOnWorkerThread())
+  {
+    QMetaObject::invokeMethod(this, "resumeSystemFromState", Qt::QueuedConnection, Q_ARG(const QString&, filename),
+                              Q_ARG(bool, boot_on_failure));
+    return;
+  }
+
+  if (filename.isEmpty())
+    HostInterface::ResumeSystemFromMostRecentState();
+  else
+    HostInterface::ResumeSystemFromState(filename.toStdString().c_str(), boot_on_failure);
+}
+
 void QtHostInterface::bootSystemFromBIOS()
 {
   if (!isOnWorkerThread())
@@ -485,22 +500,31 @@ void QtHostInterface::addButtonToInputMap(const QString& binding, InputButtonHan
   }
 }
 
-void QtHostInterface::destroySystem(bool save_resume_state /* = false */, bool block_until_done /* = false */)
+void QtHostInterface::powerOffSystem()
 {
   if (!isOnWorkerThread())
   {
-    QMetaObject::invokeMethod(this, "destroySystem",
-                              block_until_done ? Qt::BlockingQueuedConnection : Qt::QueuedConnection,
-                              Q_ARG(bool, save_resume_state), Q_ARG(bool, block_until_done));
+    QMetaObject::invokeMethod(this, "powerOffSystem", Qt::QueuedConnection);
     return;
   }
 
   if (!m_system)
     return;
 
+  if (m_settings.save_state_on_exit)
+    SaveResumeSaveState();
+
   DestroySystem();
 }
 
+void QtHostInterface::synchronousPowerOffSystem()
+{
+  if (!isOnWorkerThread())
+    QMetaObject::invokeMethod(this, "powerOffSystem", Qt::BlockingQueuedConnection);
+  else
+    powerOffSystem();
+}
+
 void QtHostInterface::resetSystem()
 {
   if (!isOnWorkerThread())
@@ -555,23 +579,26 @@ void QtHostInterface::populateSaveStateMenus(const char* game_code, QMenu* load_
   if (!available_states.empty())
   {
     bool last_global = available_states.front().global;
+    s32 last_slot = available_states.front().slot;
     for (const SaveStateInfo& ssi : available_states)
     {
       const s32 slot = ssi.slot;
       const bool global = ssi.global;
       const QDateTime timestamp(QDateTime::fromSecsSinceEpoch(static_cast<qint64>(ssi.timestamp)));
+      const QString timestamp_str(timestamp.toString(Qt::SystemLocaleShortDate));
       const QString path(QString::fromStdString(ssi.path));
 
-      QString title = tr("%1 Save %2 (%3)")
-                        .arg(global ? tr("Global") : tr("Game"))
-                        .arg(slot)
-                        .arg(timestamp.toString(Qt::SystemLocaleShortDate));
+      QString title;
+      if (slot < 0)
+        title = tr("Resume Save (%1)").arg(timestamp_str);
+      else
+        title = tr("%1 Save %2 (%3)").arg(global ? tr("Global") : tr("Game")).arg(slot).arg(timestamp_str);
 
-      if (global != last_global)
-      {
+      if (global != last_global || last_slot < 0)
         load_menu->addSeparator();
-        last_global = global;
-      }
+
+      last_global = global;
+      last_slot = slot;
 
       QAction* action = load_menu->addAction(title);
       connect(action, &QAction::triggered, [this, path]() { loadState(path); });
diff --git a/src/duckstation-qt/qthostinterface.h b/src/duckstation-qt/qthostinterface.h
index 2b20e8352..e767a6080 100644
--- a/src/duckstation-qt/qthostinterface.h
+++ b/src/duckstation-qt/qthostinterface.h
@@ -35,7 +35,7 @@ public:
   void setDefaultSettings();
 
   /// Thread-safe QSettings access.
-  QVariant getSettingValue(const QString& name);
+  QVariant getSettingValue(const QString& name, const QVariant& default_value = QVariant());
   void putSettingValue(const QString& name, const QVariant& value);
   void removeSettingValue(const QString& name);
 
@@ -77,8 +77,10 @@ Q_SIGNALS:
 public Q_SLOTS:
   void applySettings();
   void bootSystemFromFile(const QString& filename);
+  void resumeSystemFromState(const QString& filename, bool boot_on_failure);
   void bootSystemFromBIOS();
-  void destroySystem(bool save_resume_state = false, bool block_until_done = false);
+  void powerOffSystem();
+  void synchronousPowerOffSystem();
   void resetSystem();
   void pauseSystem(bool paused);
   void changeDisc(const QString& new_disc_filename);
diff --git a/src/duckstation-sdl/sdl_host_interface.cpp b/src/duckstation-sdl/sdl_host_interface.cpp
index 8e494757e..3834c2c2b 100644
--- a/src/duckstation-sdl/sdl_host_interface.cpp
+++ b/src/duckstation-sdl/sdl_host_interface.cpp
@@ -1048,7 +1048,11 @@ void SDLHostInterface::DrawPoweredOffWindow()
   ImGui::PushStyleColor(ImGuiCol_ButtonHovered, 0xFF575757);
 
   ImGui::SetCursorPosX(button_left);
-  ImGui::Button("Resume", button_size);
+  if (ImGui::Button("Resume", button_size))
+  {
+    ResumeSystemFromMostRecentState();
+    ClearImGuiFocus();
+  }
   ImGui::NewLine();
 
   ImGui::SetCursorPosX(button_left);
@@ -1163,6 +1167,7 @@ void SDLHostInterface::DrawSettingsWindow()
         settings_changed |= ImGui::SliderFloat("##speed", &m_settings.emulation_speed, 0.25f, 5.0f);
         settings_changed |= ImGui::Checkbox("Enable Speed Limiter", &m_settings.speed_limiter_enabled);
         settings_changed |= ImGui::Checkbox("Pause On Start", &m_settings.start_paused);
+        settings_changed |= ImGui::Checkbox("Save State On Exit", &m_settings.save_state_on_exit);
       }
 
       ImGui::NewLine();
@@ -1498,5 +1503,9 @@ void SDLHostInterface::Run()
 
   // Save state on exit so it can be resumed
   if (m_system)
+  {
+    if (m_settings.save_state_on_exit)
+      SaveResumeSaveState();
     DestroySystem();
+  }
 }