diff --git a/src/Sentry/Internal/Hub.cs b/src/Sentry/Internal/Hub.cs
index dade93b89f..605970ecbb 100644
--- a/src/Sentry/Internal/Hub.cs
+++ b/src/Sentry/Internal/Hub.cs
@@ -667,8 +667,17 @@ private SentryId CaptureEvent(SentryEvent evt, SentryHint? hint, Scope scope)
             {
                 // Event contains a terminal exception -> finish any current transaction as aborted
                 // Do this *after* the event was captured, so that the event is still linked to the transaction.
-                _options.LogDebug("Ending transaction as Aborted, due to unhandled exception.");
-                transaction.Finish(SpanStatus.Aborted);
+                // Skip for OpenTelemetry transactions - these get handled by the SpanProcessor instead. See https://github.com/getsentry/sentry-dotnet/pull/5310
+                if (transaction is IBaseTracer { IsOtelInstrumenter: true })
+                {
+                    _options.LogDebug(
+                        "Not ending OpenTelemetry transaction as Aborted; it is finished by the SentrySpanProcessor.");
+                }
+                else
+                {
+                    _options.LogDebug("Ending transaction as Aborted, due to unhandled exception.");
+                    transaction.Finish(SpanStatus.Aborted);
+                }
             }
 
             return id;
diff --git a/test/Sentry.Tests/HubTests.cs b/test/Sentry.Tests/HubTests.cs
index c669a97060..eea49f6250 100644
--- a/test/Sentry.Tests/HubTests.cs
+++ b/test/Sentry.Tests/HubTests.cs
@@ -545,6 +545,36 @@ public void CaptureEvent_TerminalUnhandledException_AbortsActiveTransaction()
         transaction.IsFinished.Should().BeTrue();
     }
 
+    [Fact]
+    public void CaptureEvent_TerminalUnhandledException_DoesNotAbortOpenTelemetryTransaction()
+    {
+        // OpenTelemetry-instrumented transactions are owned and finished by the SentrySpanProcessor
+        // when the underlying Activity ends (which is also where the transaction name, operation and
+        // otel/response contexts get populated). Finishing them early here would capture them with the
+        // raw activity name and no otel context. See https://github.com/getsentry/sentry-dotnet/issues/5091
+
+        // Arrange
+        _fixture.Options.TracesSampleRate = 1.0;
+        _fixture.Options.Instrumenter = Instrumenter.OpenTelemetry;
+        var hub = _fixture.GetSut();
+
+        var transactionContext = new TransactionContext("test", "operation")
+        {
+            Instrumenter = Instrumenter.OpenTelemetry
+        };
+        var transaction = hub.StartTransaction(transactionContext);
+        hub.ConfigureScope(scope => scope.Transaction = transaction);
+
+        var exception = new Exception("test");
+        exception.SetSentryMechanism("test", handled: false, terminal: true);
+
+        // Act
+        hub.CaptureEvent(new SentryEvent(exception));
+
+        // Assert
+        transaction.IsFinished.Should().BeFalse();
+    }
+
     [Fact]
     public void CaptureEvent_NonTerminalUnhandledException_DoesNotAbortActiveTransaction()
     {