diff --git a/common/CocoaTools.h b/common/CocoaTools.h
index 0ea11e747c..3afe75b447 100644
--- a/common/CocoaTools.h
+++ b/common/CocoaTools.h
@@ -22,6 +22,10 @@ namespace CocoaTools
 {
 	bool CreateMetalLayer(WindowInfo* wi);
 	void DestroyMetalLayer(WindowInfo* wi);
+	/// Add a handler to be run when macOS changes between dark and light themes
+	void AddThemeChangeHandler(void* ctx, void(handler)(void* ctx));
+	/// Remove a handler previously added using AddThemeChangeHandler with the given context
+	void RemoveThemeChangeHandler(void* ctx);
 }
 
 #endif // __APPLE__
diff --git a/common/CocoaTools.mm b/common/CocoaTools.mm
index d0b6e5e117..e81d2aaf21 100644
--- a/common/CocoaTools.mm
+++ b/common/CocoaTools.mm
@@ -20,9 +20,12 @@
 #include "CocoaTools.h"
 #include "Console.h"
 #include "WindowInfo.h"
+#include <vector>
 #include <Cocoa/Cocoa.h>
 #include <QuartzCore/QuartzCore.h>
 
+// MARK: - Metal Layers
+
 bool CocoaTools::CreateMetalLayer(WindowInfo* wi)
 {
 	if (![NSThread isMainThread])
@@ -64,3 +67,61 @@ void CocoaTools::DestroyMetalLayer(WindowInfo* wi)
 	[view setLayer:nil];
 	[view setWantsLayer:NO];
 }
+
+// MARK: - Theme Change Handlers
+
+@interface PCSX2KVOHelper : NSObject
+
+- (void)addCallback:(void*)ctx run:(void(*)(void*))callback;
+- (void)removeCallback:(void*)ctx;
+
+@end
+
+@implementation PCSX2KVOHelper
+{
+	std::vector<std::pair<void*, void(*)(void*)>> _callbacks;
+}
+
+- (void)addCallback:(void*)ctx run:(void(*)(void*))callback
+{
+	_callbacks.push_back(std::make_pair(ctx, callback));
+}
+
+- (void)removeCallback:(void*)ctx
+{
+	auto new_end = std::remove_if(_callbacks.begin(), _callbacks.end(), [ctx](const auto& entry){
+		return ctx == entry.first;
+	});
+	_callbacks.erase(new_end, _callbacks.end());
+}
+
+- (void)observeValueForKeyPath:(NSString *)keyPath ofObject:(id)object change:(NSDictionary<NSKeyValueChangeKey,id> *)change context:(void *)context
+{
+	for (const auto& callback : _callbacks)
+		callback.second(callback.first);
+}
+
+@end
+
+static PCSX2KVOHelper* s_themeChangeHandler;
+
+void CocoaTools::AddThemeChangeHandler(void* ctx, void(handler)(void* ctx))
+{
+	assert([NSThread isMainThread]);
+	if (!s_themeChangeHandler)
+	{
+		s_themeChangeHandler = [[PCSX2KVOHelper alloc] init];
+		NSApplication* app = [NSApplication sharedApplication];
+		[app addObserver:s_themeChangeHandler
+		      forKeyPath:@"effectiveAppearance"
+		         options:0
+		         context:nil];
+	}
+	[s_themeChangeHandler addCallback:ctx run:handler];
+}
+
+void CocoaTools::RemoveThemeChangeHandler(void* ctx)
+{
+	assert([NSThread isMainThread]);
+	[s_themeChangeHandler removeCallback:ctx];
+}
diff --git a/pcsx2-qt/MainWindow.cpp b/pcsx2-qt/MainWindow.cpp
index cb64cccafd..3bac98d1b8 100644
--- a/pcsx2-qt/MainWindow.cpp
+++ b/pcsx2-qt/MainWindow.cpp
@@ -24,6 +24,7 @@
 #include <QtWidgets/QStyleFactory>
 
 #include "common/Assertions.h"
+#include "common/CocoaTools.h"
 #include "common/FileSystem.h"
 
 #include "pcsx2/CDVD/CDVDaccess.h"
@@ -84,12 +85,25 @@ MainWindow::~MainWindow()
 	// we compare here, since recreate destroys the window later
 	if (g_main_window == this)
 		g_main_window = nullptr;
+#ifdef __APPLE__
+	CocoaTools::RemoveThemeChangeHandler(this);
+#endif
 }
 
 void MainWindow::initialize()
 {
 	setStyleFromSettings();
 	setIconThemeFromStyle();
+#ifdef __APPLE__
+	CocoaTools::AddThemeChangeHandler(this, [](void* ctx){
+		// This handler is called *before* the style change has propagated far enough for Qt to see it
+		// Use RunOnUIThread to delay until it has
+		QtHost::RunOnUIThread([ctx = static_cast<MainWindow*>(ctx)]{
+			ctx->setStyleFromSettings(); // Qt won't notice the style change without us touching the palette in some way
+			ctx->setIconThemeFromStyle();
+		});
+	});
+#endif
 	m_ui.setupUi(this);
 	setupAdditionalUi();
 	connectSignals();