diff --git a/pcsx2/Frontend/MetalHostDisplay.h b/pcsx2/Frontend/MetalHostDisplay.h
index 6698033cbf..aed0b5f5c2 100644
--- a/pcsx2/Frontend/MetalHostDisplay.h
+++ b/pcsx2/Frontend/MetalHostDisplay.h
@@ -31,6 +31,12 @@
 
 class MetalHostDisplay final : public HostDisplay
 {
+	enum class UsePresentDrawable : u8
+	{
+		Never = 0,
+		Always = 1,
+		IfVsync = 2,
+	};
 	MRCOwned<NSView*> m_view;
 	MRCOwned<CAMetalLayer*> m_layer;
 	GSMTLDevice m_dev;
@@ -39,6 +45,7 @@ class MetalHostDisplay final : public HostDisplay
 	MRCOwned<id<CAMetalDrawable>> m_current_drawable;
 	MRCOwned<MTLRenderPassDescriptor*> m_pass_desc;
 	u32 m_capture_start_frame;
+	UsePresentDrawable m_use_present_drawable;
 	bool m_gpu_timing_enabled = false;
 	double m_accumulated_gpu_time = 0;
 	double m_last_gpu_time_end = 0;
diff --git a/pcsx2/Frontend/MetalHostDisplay.mm b/pcsx2/Frontend/MetalHostDisplay.mm
index 46f8dae67c..e51b567756 100644
--- a/pcsx2/Frontend/MetalHostDisplay.mm
+++ b/pcsx2/Frontend/MetalHostDisplay.mm
@@ -129,6 +129,13 @@ bool MetalHostDisplay::CreateDevice(const WindowInfo& wi)
 	[m_pass_desc colorAttachments][0].clearColor = MTLClearColorMake(0, 0, 0, 0);
 	[m_pass_desc colorAttachments][0].storeAction = MTLStoreActionStore;
 
+	if (char* env = getenv("MTL_USE_PRESENT_DRAWABLE"))
+		m_use_present_drawable = static_cast<UsePresentDrawable>(atoi(env));
+	else if (@available(macOS 13.0, *))
+		m_use_present_drawable = UsePresentDrawable::Always;
+	else // Before Ventura, presentDrawable acts like vsync is on when windowed
+		m_use_present_drawable = UsePresentDrawable::IfVsync;
+
 	m_capture_start_frame = 0;
 	if (char* env = getenv("MTL_CAPTURE"))
 	{
@@ -294,9 +301,17 @@ void MetalHostDisplay::EndPresent()
 	dev->RenderImGui(ImGui::GetDrawData());
 	dev->EndRenderPass();
 	if (m_current_drawable)
-		[dev->m_current_render_cmdbuf addScheduledHandler:[drawable = std::move(m_current_drawable)](id<MTLCommandBuffer>){
-			[drawable present];
-		}];
+	{
+		const bool use_present_drawable = m_use_present_drawable == UsePresentDrawable::Always ||
+			(m_use_present_drawable == UsePresentDrawable::IfVsync && m_vsync_mode != VsyncMode::Off);
+
+		if (use_present_drawable)
+			[dev->m_current_render_cmdbuf presentDrawable:m_current_drawable];
+		else
+			[dev->m_current_render_cmdbuf addScheduledHandler:[drawable = std::move(m_current_drawable)](id<MTLCommandBuffer>){
+				[drawable present];
+			}];
+	}
 	dev->FlushEncoders();
 	dev->FrameCompleted();
 	m_current_drawable = nullptr;