diff --git a/pcsx2-qt/CMakeLists.txt b/pcsx2-qt/CMakeLists.txt
index a5db7b76c1..9b35add7f0 100644
--- a/pcsx2-qt/CMakeLists.txt
+++ b/pcsx2-qt/CMakeLists.txt
@@ -213,6 +213,7 @@ target_link_libraries(pcsx2-qt PRIVATE
 target_compile_definitions(pcsx2-qt PRIVATE QT_NO_EXCEPTIONS)
 
 if(WIN32)
+	target_sources(pcsx2-qt PRIVATE VCRuntimeChecker.cpp)
 	set_source_files_properties(${TS_FILES} PROPERTIES OUTPUT_LOCATION "${CMAKE_SOURCE_DIR}/bin/translations")
 	qt_add_lrelease(pcsx2-qt TS_FILES ${TS_FILES})
 	copy_base_translations(pcsx2-qt)
diff --git a/pcsx2-qt/VCRuntimeChecker.cpp b/pcsx2-qt/VCRuntimeChecker.cpp
new file mode 100644
index 0000000000..ba3f7f387f
--- /dev/null
+++ b/pcsx2-qt/VCRuntimeChecker.cpp
@@ -0,0 +1,108 @@
+// SPDX-FileCopyrightText: 2002-2023 PCSX2 Dev Team
+// SPDX-License-Identifier: LGPL-3.0+
+
+#include "common/RedtapeWindows.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 PCSX2.\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, PCSX2 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;
diff --git a/pcsx2-qt/pcsx2-qt.vcxproj b/pcsx2-qt/pcsx2-qt.vcxproj
index 42abb7f53f..54e1aedbc6 100644
--- a/pcsx2-qt/pcsx2-qt.vcxproj
+++ b/pcsx2-qt/pcsx2-qt.vcxproj
@@ -151,6 +151,7 @@
     <ClCompile Include="QtKeyCodes.cpp" />
     <ClCompile Include="QtUtils.cpp" />
     <ClCompile Include="Translations.cpp" />
+    <ClCompile Include="VCRuntimeChecker.cpp" />
   </ItemGroup>
   <ItemGroup>
     <QtMoc Include="SetupWizardDialog.h" />
diff --git a/pcsx2-qt/pcsx2-qt.vcxproj.filters b/pcsx2-qt/pcsx2-qt.vcxproj.filters
index 40a3fa79fc..366cc8188b 100644
--- a/pcsx2-qt/pcsx2-qt.vcxproj.filters
+++ b/pcsx2-qt/pcsx2-qt.vcxproj.filters
@@ -355,6 +355,7 @@
     <ClCompile Include="Debugger\DebuggerSettingsManager.cpp">
       <Filter>Debugger</Filter>
     </ClCompile>
+    <ClCompile Include="VCRuntimeChecker.cpp" />
   </ItemGroup>
   <ItemGroup>
     <Manifest Include="..\pcsx2\windows\PCSX2.manifest">