diff --git a/.cirrus.yml b/.cirrus.yml
index 531cfe96f6..9f2282471a 100644
--- a/.cirrus.yml
+++ b/.cirrus.yml
@@ -447,7 +447,7 @@ task:
   # Use /DEBUG:FASTLINK to avoid high memory usage during linking
   configure_script: |
     vcvarsall x64
-    meson setup --backend ninja --buildtype debug -Dc_link_args=/DEBUG:FASTLINK -Dcassert=true -Dssl=openssl -Dextra_lib_dirs=c:\openssl\1.1\lib -Dextra_include_dirs=c:\openssl\1.1\include -DTAR=c:/windows/system32/tar.exe -DPG_TEST_EXTRA="%PG_TEST_EXTRA%" build
+    meson setup --backend ninja --buildtype debug -Dc_link_args=/DEBUG:FASTLINK -Dcassert=true -Db_pch=true -Dssl=openssl -Dextra_lib_dirs=c:\openssl\1.1\lib -Dextra_include_dirs=c:\openssl\1.1\include -DTAR=c:/windows/system32/tar.exe -DPG_TEST_EXTRA="%PG_TEST_EXTRA%" build
 
   build_script: |
     vcvarsall x64
diff --git a/contrib/bloom/meson.build b/contrib/bloom/meson.build
index 16f3b83e4d..163a93c98f 100644
--- a/contrib/bloom/meson.build
+++ b/contrib/bloom/meson.build
@@ -15,6 +15,7 @@ endif
 
 bloom = shared_module('bloom',
   bloom_sources,
+  c_pch: pch_postgres_h,
   kwargs: contrib_mod_args,
 )
 contrib_targets += bloom
diff --git a/contrib/btree_gist/meson.build b/contrib/btree_gist/meson.build
index e98c91dacc..bfb7865d21 100644
--- a/contrib/btree_gist/meson.build
+++ b/contrib/btree_gist/meson.build
@@ -33,6 +33,7 @@ endif
 
 btree_gist = shared_module('btree_gist',
   btree_gist_sources,
+  c_pch: pch_postgres_h,
   kwargs: contrib_mod_args,
 )
 contrib_targets += btree_gist
diff --git a/contrib/hstore/meson.build b/contrib/hstore/meson.build
index 2bb26bb772..a2a4ec36cb 100644
--- a/contrib/hstore/meson.build
+++ b/contrib/hstore/meson.build
@@ -18,6 +18,7 @@ endif
 
 hstore = shared_module('hstore',
   hstore_sources,
+  c_pch: pch_postgres_h,
   kwargs: contrib_mod_args,
 )
 contrib_targets += hstore
diff --git a/contrib/pg_trgm/meson.build b/contrib/pg_trgm/meson.build
index c8c7c07b30..839d6c4a7f 100644
--- a/contrib/pg_trgm/meson.build
+++ b/contrib/pg_trgm/meson.build
@@ -13,6 +13,7 @@ endif
 
 pg_trgm = shared_module('pg_trgm',
   pg_trgm_sources,
+  c_pch: pch_postgres_h,
   kwargs: contrib_mod_args,
 )
 contrib_targets += pg_trgm
diff --git a/contrib/pgcrypto/meson.build b/contrib/pgcrypto/meson.build
index 7fc7bbc7ca..cc782578b4 100644
--- a/contrib/pgcrypto/meson.build
+++ b/contrib/pgcrypto/meson.build
@@ -78,6 +78,7 @@ endif
 pgcrypto = shared_module('pgcrypto',
   pgcrypto_sources,
   link_with: pgcrypto_link_with,
+  c_pch: pch_postgres_h,
   kwargs: contrib_mod_args + {
     'dependencies': [pgcrypto_deps, contrib_mod_args['dependencies']]
   },
diff --git a/contrib/pgstattuple/meson.build b/contrib/pgstattuple/meson.build
index 05e4cd46a5..42d0b0e6ce 100644
--- a/contrib/pgstattuple/meson.build
+++ b/contrib/pgstattuple/meson.build
@@ -12,6 +12,7 @@ endif
 
 pgstattuple = shared_module('pgstattuple',
   pgstattuple_sources,
+  c_pch: pch_postgres_h,
   kwargs: contrib_mod_args,
 )
 contrib_targets += pgstattuple
diff --git a/contrib/sepgsql/meson.build b/contrib/sepgsql/meson.build
index 8bef239e3c..1ac0fa388a 100644
--- a/contrib/sepgsql/meson.build
+++ b/contrib/sepgsql/meson.build
@@ -22,6 +22,7 @@ endif
 
 sepgsql = shared_module('sepgsql',
   sepgsql_sources,
+  c_pch: pch_postgres_h,
   kwargs: contrib_mod_args + {
     'dependencies': [selinux, contrib_mod_args['dependencies']],
   }
diff --git a/contrib/xml2/meson.build b/contrib/xml2/meson.build
index 89b0d67751..92ab336842 100644
--- a/contrib/xml2/meson.build
+++ b/contrib/xml2/meson.build
@@ -15,6 +15,7 @@ endif
 
 xml2 = shared_module('pgxml',
   xml2_sources,
+  c_pch: pch_postgres_h,
   kwargs: contrib_mod_args + {
     'dependencies': [libxml, libxslt, contrib_mod_args['dependencies']],
   },
diff --git a/meson.build b/meson.build
index 25a6fa941c..f0cb01c001 100644
--- a/meson.build
+++ b/meson.build
@@ -15,6 +15,7 @@ project('postgresql',
   meson_version: '>=0.54',
   default_options: [
     'warning_level=1', #-Wall equivalent
+    'b_pch=false',
     'buildtype=release',
     # For compatibility with the autoconf build, set a default prefix. This
     # works even on windows, where it's a drive-relative path (i.e. when on
diff --git a/src/backend/meson.build b/src/backend/meson.build
index 6f4cd6ceb0..37562bae13 100644
--- a/src/backend/meson.build
+++ b/src/backend/meson.build
@@ -62,6 +62,7 @@ postgres_lib = static_library('postgres_lib',
   backend_sources + timezone_sources + generated_backend_sources,
   link_whole: backend_link_with,
   dependencies: backend_build_deps,
+  c_pch: pch_postgres_h,
   kwargs: internal_lib_args,
 )
 
@@ -81,6 +82,10 @@ if cc.get_id() == 'msvc'
 
   backend_link_args += '/DEF:@0@'.format(postgres_def.full_path())
   backend_link_depends += postgres_def
+  # Due to the way msvc and meson's precompiled headers implementation
+  # interact, we need to have symbols from the full library available. Could
+  # be restricted to b_pch=true.
+  backend_link_with += postgres_lib
 
 elif host_system == 'aix'
   # The '.' argument leads mkldexport.sh to emit "#! .", which refers to the
diff --git a/src/backend/snowball/meson.build b/src/backend/snowball/meson.build
index 974401d187..72959fa29d 100644
--- a/src/backend/snowball/meson.build
+++ b/src/backend/snowball/meson.build
@@ -66,6 +66,7 @@ endif
 
 dict_snowball = shared_module('dict_snowball',
   dict_snowball_sources,
+  c_pch: pch_postgres_h,
   kwargs: pg_mod_args + {
     'include_directories': [stemmer_inc],
   }
diff --git a/src/bin/pg_dump/meson.build b/src/bin/pg_dump/meson.build
index 3527a25c28..e66f632b54 100644
--- a/src/bin/pg_dump/meson.build
+++ b/src/bin/pg_dump/meson.build
@@ -13,6 +13,7 @@ pg_dump_common_sources = files(
 
 pg_dump_common = static_library('libpgdump_common',
   pg_dump_common_sources,
+  c_pch: pch_postgres_fe_h,
   dependencies: [frontend_code, libpq, zlib],
   kwargs: internal_lib_args,
 )
diff --git a/src/bin/pg_upgrade/meson.build b/src/bin/pg_upgrade/meson.build
index a7b927a45c..212bc9ce6e 100644
--- a/src/bin/pg_upgrade/meson.build
+++ b/src/bin/pg_upgrade/meson.build
@@ -24,6 +24,7 @@ endif
 
 pg_upgrade = executable('pg_upgrade',
   pg_upgrade_sources,
+  c_pch: pch_postgres_fe_h,
   dependencies: [frontend_code, libpq],
   kwargs: default_bin_args,
 )
diff --git a/src/bin/pgbench/meson.build b/src/bin/pgbench/meson.build
index 3cc393d17e..1a3ec5d129 100644
--- a/src/bin/pgbench/meson.build
+++ b/src/bin/pgbench/meson.build
@@ -27,6 +27,7 @@ pgbench = executable('pgbench',
   pgbench_sources,
   dependencies: [frontend_code, libpq, thread_dep],
   include_directories: include_directories('.'),
+  c_pch: pch_postgres_fe_h,
   c_args: host_system == 'windows' ? ['-DFD_SETSIZE=1024'] : [],
   kwargs: default_bin_args,
 )
diff --git a/src/bin/psql/meson.build b/src/bin/psql/meson.build
index 1264fc19fb..a4c46bf538 100644
--- a/src/bin/psql/meson.build
+++ b/src/bin/psql/meson.build
@@ -44,6 +44,7 @@ endif
 
 psql = executable('psql',
   psql_sources,
+  c_pch: pch_postgres_fe_h,
   include_directories: include_directories('.'),
   dependencies: [frontend_code, libpq, readline],
   kwargs: default_bin_args,
diff --git a/src/common/meson.build b/src/common/meson.build
index 23842e1ffe..1c9b8a3a01 100644
--- a/src/common/meson.build
+++ b/src/common/meson.build
@@ -147,6 +147,7 @@ foreach name, opts : pgcommon_variants
     endif
     c_args = opts.get('c_args', []) + common_cflags[cflagname]
     cflag_libs += static_library('libpgcommon@0@_@1@'.format(name, cflagname),
+      c_pch: pch_c_h,
       include_directories: include_directories('.'),
       kwargs: opts + {
         'sources': sources,
@@ -159,6 +160,7 @@ foreach name, opts : pgcommon_variants
 
   lib = static_library('libpgcommon@0@'.format(name),
       link_with: cflag_libs,
+      c_pch: pch_c_h,
       include_directories: include_directories('.'),
       kwargs: opts + {
         'dependencies': opts['dependencies'] + [ssl],
diff --git a/src/fe_utils/meson.build b/src/fe_utils/meson.build
index 3e226c260a..fe0b801387 100644
--- a/src/fe_utils/meson.build
+++ b/src/fe_utils/meson.build
@@ -23,6 +23,7 @@ fe_utils_sources += psqlscan
 
 fe_utils = static_library('libpgfeutils',
   fe_utils_sources + generated_headers,
+  c_pch: pch_postgres_fe_h,
   include_directories: [postgres_inc, libpq_inc],
   c_args: host_system == 'windows' ? ['-DFD_SETSIZE=1024'] : [],
   dependencies: frontend_common_code,
diff --git a/src/include/meson.build b/src/include/meson.build
index f2f7d03ff2..35c06c4856 100644
--- a/src/include/meson.build
+++ b/src/include/meson.build
@@ -114,6 +114,7 @@ install_headers(
 
 subdir('catalog')
 subdir('nodes')
+subdir('pch')
 subdir('storage')
 subdir('utils')
 
diff --git a/src/include/pch/c_pch.h b/src/include/pch/c_pch.h
new file mode 100644
index 0000000000..f40c757ca6
--- /dev/null
+++ b/src/include/pch/c_pch.h
@@ -0,0 +1 @@
+#include "c.h"
diff --git a/src/include/pch/meson.build b/src/include/pch/meson.build
new file mode 100644
index 0000000000..2bcec49c3a
--- /dev/null
+++ b/src/include/pch/meson.build
@@ -0,0 +1,4 @@
+# See https://github.com/mesonbuild/meson/issues/10338
+pch_c_h = meson.source_root() / meson.current_source_dir() / 'c_pch.h'
+pch_postgres_h = meson.source_root() / meson.current_source_dir() / 'postgres_pch.h'
+pch_postgres_fe_h = meson.source_root() / meson.current_source_dir() / 'postgres_fe_pch.h'
diff --git a/src/include/pch/postgres_fe_pch.h b/src/include/pch/postgres_fe_pch.h
new file mode 100644
index 0000000000..f3ea20912d
--- /dev/null
+++ b/src/include/pch/postgres_fe_pch.h
@@ -0,0 +1 @@
+#include "postgres_fe.h"
diff --git a/src/include/pch/postgres_pch.h b/src/include/pch/postgres_pch.h
new file mode 100644
index 0000000000..71b2f35f76
--- /dev/null
+++ b/src/include/pch/postgres_pch.h
@@ -0,0 +1 @@
+#include "postgres.h"
diff --git a/src/interfaces/ecpg/ecpglib/meson.build b/src/interfaces/ecpg/ecpglib/meson.build
index 7e6e6fbf5c..2d07da1ff4 100644
--- a/src/interfaces/ecpg/ecpglib/meson.build
+++ b/src/interfaces/ecpg/ecpglib/meson.build
@@ -27,6 +27,7 @@ ecpglib_st = static_library('libecpg',
   ecpglib_sources,
   include_directories: ecpglib_inc,
   c_args: ecpglib_c_args,
+  c_pch: pch_postgres_fe_h,
   dependencies: [frontend_stlib_code, thread_dep, libpq],
   link_with: [ecpg_pgtypes_st],
   kwargs: default_lib_args,
@@ -37,6 +38,7 @@ ecpglib_so = shared_library('libecpg',
   ecpglib_sources + ecpglib_so_sources,
   include_directories: ecpglib_inc,
   c_args: ecpglib_c_args,
+  c_pch: pch_postgres_fe_h,
   dependencies: [frontend_shlib_code, libpq, thread_dep],
   link_with: ecpg_pgtypes_so,
   soversion: host_system != 'windows' ? '6' : '',
diff --git a/src/interfaces/ecpg/pgtypeslib/meson.build b/src/interfaces/ecpg/pgtypeslib/meson.build
index 530dd2c602..d7e1a94d24 100644
--- a/src/interfaces/ecpg/pgtypeslib/meson.build
+++ b/src/interfaces/ecpg/pgtypeslib/meson.build
@@ -23,6 +23,7 @@ ecpg_pgtypes_st = static_library('libpgtypes',
   ecpg_pgtypes_sources,
   include_directories: ecpg_pgtypes_inc,
   c_args: ecpg_pgtypes_c_args,
+  c_pch: pch_postgres_fe_h,
   dependencies: frontend_stlib_code,
   kwargs: default_lib_args,
 )
@@ -32,6 +33,7 @@ ecpg_pgtypes_so = shared_library('libpgtypes',
   ecpg_pgtypes_sources + ecpg_pgtypes_so_sources,
   include_directories: ecpg_pgtypes_inc,
   c_args: ecpg_pgtypes_c_args,
+  c_pch: pch_postgres_fe_h,
   dependencies: frontend_shlib_code,
   version: '3.' + pg_version_major.to_string(),
   soversion: host_system != 'windows' ? '3' : '',
diff --git a/src/interfaces/ecpg/preproc/meson.build b/src/interfaces/ecpg/preproc/meson.build
index 74876f039c..3d42ee439f 100644
--- a/src/interfaces/ecpg/preproc/meson.build
+++ b/src/interfaces/ecpg/preproc/meson.build
@@ -102,6 +102,7 @@ endif
 ecpg_exe = executable('ecpg',
   ecpg_sources,
   include_directories: ['.', ecpg_inc, postgres_inc, libpq_inc],
+  c_pch: pch_postgres_fe_h,
   dependencies: [frontend_code],
   kwargs: default_bin_args,
 )
diff --git a/src/interfaces/libpq/meson.build b/src/interfaces/libpq/meson.build
index 533b2e6f77..8e696f1183 100644
--- a/src/interfaces/libpq/meson.build
+++ b/src/interfaces/libpq/meson.build
@@ -58,6 +58,7 @@ libpq_st = static_library('libpq',
   libpq_sources,
   include_directories: [libpq_inc],
   c_args: libpq_c_args,
+  c_pch: pch_postgres_fe_h,
   dependencies: [frontend_stlib_code, libpq_deps],
   kwargs: default_lib_args,
 )
@@ -66,6 +67,7 @@ libpq_so = shared_library('libpq',
   libpq_sources + libpq_so_sources,
   include_directories: [libpq_inc, postgres_inc],
   c_args: libpq_c_args,
+  c_pch: pch_postgres_fe_h,
   version: '5.' + pg_version_major.to_string(),
   soversion: host_system != 'windows' ? '5' : '',
   darwin_versions: ['5', '5.' + pg_version_major.to_string()],
diff --git a/src/pl/plperl/meson.build b/src/pl/plperl/meson.build
index 535660085d..cd3894e6a7 100644
--- a/src/pl/plperl/meson.build
+++ b/src/pl/plperl/meson.build
@@ -45,6 +45,7 @@ endif
 
 plperl = shared_module('plperl',
   plperl_sources,
+  c_pch: pch_postgres_h,
   include_directories: [plperl_inc, postgres_inc],
   kwargs: pg_mod_args + {
     'dependencies': [perl_dep, pg_mod_args['dependencies']],
diff --git a/src/pl/plpgsql/src/meson.build b/src/pl/plpgsql/src/meson.build
index c46c0a1da2..27b2f5ef52 100644
--- a/src/pl/plpgsql/src/meson.build
+++ b/src/pl/plpgsql/src/meson.build
@@ -48,6 +48,7 @@ endif
 
 plpgsql = shared_module('plpgsql',
   plpgsql_sources,
+  c_pch: pch_postgres_h,
   include_directories: include_directories('.'),
   kwargs: pg_mod_args,
 )
diff --git a/src/pl/plpython/meson.build b/src/pl/plpython/meson.build
index 40888386b5..7bd683580e 100644
--- a/src/pl/plpython/meson.build
+++ b/src/pl/plpython/meson.build
@@ -36,6 +36,7 @@ endif
 
 plpython = shared_module('plpython3',
   plpython_sources,
+  c_pch: pch_postgres_h,
   include_directories: [plpython_inc, postgres_inc],
   kwargs: pg_mod_args + {
     'dependencies': [python3_dep, pg_mod_args['dependencies']],
diff --git a/src/pl/tcl/meson.build b/src/pl/tcl/meson.build
index f09bb14c95..7a708776c9 100644
--- a/src/pl/tcl/meson.build
+++ b/src/pl/tcl/meson.build
@@ -22,6 +22,7 @@ endif
 
 pltcl = shared_module('pltcl',
   pltcl_sources,
+  c_pch: pch_postgres_h,
   include_directories: [include_directories('.'), postgres_inc],
   kwargs: pg_mod_args + {
     'dependencies': [tcl_dep, pg_mod_args['dependencies']],
diff --git a/src/port/meson.build b/src/port/meson.build
index ced2e014db..c2222696f1 100644
--- a/src/port/meson.build
+++ b/src/port/meson.build
@@ -161,6 +161,7 @@ foreach name, opts : pgport_variants
     c_args = opts.get('c_args', []) + pgport_cflags[cflagname]
     cflag_libs += static_library('libpgport@0@_@1@'.format(name, cflagname),
       sources,
+      c_pch: pch_c_h,
       kwargs: opts + {
         'c_args': c_args,
         'build_by_default': false,
@@ -172,6 +173,7 @@ foreach name, opts : pgport_variants
   lib = static_library('libpgport@0@'.format(name),
       pgport_sources,
       link_with: cflag_libs,
+      c_pch: pch_c_h,
       kwargs: opts + {
         'dependencies': opts['dependencies'] + [ssl],
       }