diff --git a/lua/mason-core/installer/compiler/compilers/npm.lua b/lua/mason-core/installer/compiler/compilers/npm.lua
index e8489fe8d..c442295de 100644
--- a/lua/mason-core/installer/compiler/compilers/npm.lua
+++ b/lua/mason-core/installer/compiler/compilers/npm.lua
@@ -1,6 +1,7 @@
 local Result = require "mason-core.result"
 local _ = require "mason-core.functional"
 local providers = require "mason-core.providers"
+local settings = require "mason.settings"
 
 ---@param purl Purl
 local function purl_to_npm(purl)
@@ -33,11 +34,11 @@ end
 ---@param ctx InstallContext
 ---@param source ParsedNpmSource
 function M.install(ctx, source)
-    local npm = require "mason-core.installer.managers.npm"
-
+    local manager = settings.current.npm.use_pnpm and require "mason-core.installer.managers.pnpm"
+        or require "mason-core.installer.managers.npm"
     return Result.try(function(try)
-        try(npm.init())
-        try(npm.install(source.package, source.version, {
+        try(manager.init())
+        try(manager.install(source.package, source.version, {
             extra_packages = source.extra_packages,
         }))
     end)
diff --git a/lua/mason-core/installer/compiler/link.lua b/lua/mason-core/installer/compiler/link.lua
index d60fce478..92f7a6aa8 100644
--- a/lua/mason-core/installer/compiler/link.lua
+++ b/lua/mason-core/installer/compiler/link.lua
@@ -7,6 +7,7 @@ local fs = require "mason-core.fs"
 local log = require "mason-core.log"
 local path = require "mason-core.path"
 local platform = require "mason-core.platform"
+local settings = require "mason.settings"
 
 local M = {}
 
@@ -112,8 +113,20 @@ local bin_delegates = {
     ["nuget"] = function(target)
         return require("mason-core.installer.managers.nuget").bin_path(target)
     end,
-    ["npm"] = function(target)
-        return require("mason-core.installer.managers.npm").bin_path(target)
+    ["npm"] = function(target, bin)
+        local manager = settings.current.npm.use_pnpm and require "mason-core.installer.managers.pnpm"
+            or require "mason-core.installer.managers.npm"
+        local bin_path_result = manager.bin_path(target)
+        if not settings.current.npm.use_pnpm then
+            return bin_path_result
+        end
+        return bin_path_result:and_then(function(bin_path)
+            local installer = require "mason-core.installer"
+            local ctx = installer.context()
+            return Result.pcall(function()
+                return ctx:write_exec_wrapper(bin, bin_path)
+            end)
+        end)
     end,
     ["gem"] = function(target)
         return require("mason-core.installer.managers.gem").create_bin_wrapper(target)
diff --git a/lua/mason-core/installer/managers/pnpm.lua b/lua/mason-core/installer/managers/pnpm.lua
new file mode 100644
index 000000000..a6cc0bc91
--- /dev/null
+++ b/lua/mason-core/installer/managers/pnpm.lua
@@ -0,0 +1,51 @@
+local Result = require "mason-core.result"
+local _ = require "mason-core.functional"
+local installer = require "mason-core.installer"
+local log = require "mason-core.log"
+local path = require "mason-core.path"
+local platform = require "mason-core.platform"
+
+local M = {}
+
+---@async
+function M.init()
+    log.debug "pnpm: init"
+    local ctx = installer.context()
+    return Result.try(function(try)
+        try(ctx.spawn.pnpm { "init" })
+        local package_json = try(Result.pcall(vim.json.decode, ctx.fs:read_file "package.json"))
+        package_json.name = "@mason/" .. package_json.name
+        ctx.fs:write_file("package.json", try(Result.pcall(vim.json.encode, package_json)))
+        ctx.stdio_sink:stdout "Initialized pnpm root.\n"
+    end)
+end
+
+---@async
+---@param pkg string
+---@param version string
+---@param opts? { extra_packages?: string[] }
+function M.install(pkg, version, opts)
+    opts = opts or {}
+    log.fmt_debug("pnpm: add %s %s %s", pkg, version, opts)
+    local ctx = installer.context()
+    ctx.stdio_sink:stdout(("Installing npm package %s@%s…\n"):format(pkg, version))
+    return ctx.spawn.pnpm {
+        "add",
+        ("%s@%s"):format(pkg, version),
+        opts.extra_packages or vim.NIL,
+    }
+end
+
+---@param exec string
+function M.bin_path(exec)
+    return Result.pcall(platform.when, {
+        unix = function()
+            return path.concat { "node_modules", ".bin", exec }
+        end,
+        win = function()
+            return path.concat { "node_modules", ".bin", ("%s.cmd"):format(exec) }
+        end,
+    })
+end
+
+return M
diff --git a/lua/mason/health.lua b/lua/mason/health.lua
index b105940d0..63b19b867 100644
--- a/lua/mason/health.lua
+++ b/lua/mason/health.lua
@@ -182,11 +182,14 @@ local function check_languages()
         check_thunk { cmd = "composer", args = { "--version" }, name = "Composer", relaxed = true },
         check_thunk { cmd = "php", args = { "--version" }, name = "PHP", relaxed = true },
         check_thunk {
-            cmd = "npm",
+            cmd = settings.current.npm.use_pnpm and "pnpm" or "npm",
             args = { "--version" },
-            name = "npm",
+            name = settings.current.npm.use_pnpm and "pnpm" or "npm",
             relaxed = true,
             version_check = function(version)
+                if settings.current.npm.use_pnpm then
+                    return
+                end
                 -- Parses output such as "8.1.2" into major, minor, patch components
                 local _, _, major = version:find "(%d+)%.(%d+)%.(%d+)"
                 -- Based off of general observations of feature parity.
diff --git a/lua/mason/settings.lua b/lua/mason/settings.lua
index ebff1e0b4..1060108c6 100644
--- a/lua/mason/settings.lua
+++ b/lua/mason/settings.lua
@@ -55,6 +55,12 @@ local DEFAULT_SETTINGS = {
         download_url_template = "https://github.com/%s/releases/download/%s/%s",
     },
 
+    npm = {
+        ---@since 2.0.0
+        -- Use `pnpm` instead of `npm` to install node packages
+        use_pnpm = false,
+    },
+
     pip = {
         ---@since 1.0.0
         -- Whether to upgrade pip to the latest version in the virtual environment before installing packages.
diff --git a/tests/mason-core/installer/compiler/compilers/npm_spec.lua b/tests/mason-core/installer/compiler/compilers/npm_spec.lua
index 94d678019..38ebe9e2f 100644
--- a/tests/mason-core/installer/compiler/compilers/npm_spec.lua
+++ b/tests/mason-core/installer/compiler/compilers/npm_spec.lua
@@ -56,4 +56,26 @@ describe("npm compiler :: installing", function()
         assert.spy(manager.install).was_called(1)
         assert.spy(manager.install).was_called_with("@namespace/package", "v1.5.0", { extra_packages = { "extra" } })
     end)
+
+    it("should install npm packages when use_pnpm is set to true", function()
+        local ctx = create_dummy_context()
+        local manager = require "mason-core.installer.managers.pnpm"
+        local settings = require "mason.settings"
+        settings.current.npm.use_pnpm = true
+        stub(manager, "init", mockx.returns(Result.success()))
+        stub(manager, "install", mockx.returns(Result.success()))
+
+        local result = installer.exec_in_context(ctx, function()
+            return npm.install(ctx, {
+                package = "@namespace/package",
+                version = "v1.5.0",
+                extra_packages = { "extra" },
+            })
+        end)
+
+        assert.is_true(result:is_success())
+        assert.spy(manager.init).was_called(1)
+        assert.spy(manager.install).was_called(1)
+        assert.spy(manager.install).was_called_with("@namespace/package", "v1.5.0", { extra_packages = { "extra" } })
+    end)
 end)
diff --git a/tests/mason-core/installer/managers/pnpm_spec.lua b/tests/mason-core/installer/managers/pnpm_spec.lua
new file mode 100644
index 000000000..2929d9329
--- /dev/null
+++ b/tests/mason-core/installer/managers/pnpm_spec.lua
@@ -0,0 +1,46 @@
+local Result = require "mason-core.result"
+local installer = require "mason-core.installer"
+local match = require "luassert.match"
+local pnpm = require "mason-core.installer.managers.pnpm"
+local spawn = require "mason-core.spawn"
+local spy = require "luassert.spy"
+local stub = require "luassert.stub"
+
+describe("pnpm manager", function()
+    it("should init package.json", function()
+        local ctx = create_dummy_context()
+        stub(ctx.fs, "read_file")
+        stub(ctx.fs, "write_file")
+        stub(spawn, "pnpm")
+        ctx.fs.read_file.returns '{"name": "my-package", "version": "1.0.0"}'
+        spawn.pnpm.returns(Result.success {})
+        installer.exec_in_context(ctx, function()
+            pnpm.init()
+        end)
+
+        assert.spy(ctx.spawn.pnpm).was_called(1)
+        assert.spy(ctx.spawn.pnpm).was_called_with { "init" }
+        assert.spy(ctx.fs.read_file).was_called(1)
+        assert.spy(ctx.fs.read_file).was_called_with(match.is_ref(ctx.fs), "package.json")
+        assert.spy(ctx.fs.write_file).was_called(1)
+        assert
+            .spy(ctx.fs.write_file)
+            .was_called_with(match.is_ref(ctx.fs), "package.json", match.has_match '"name":"@mason/my--package"')
+    end)
+
+    it("should install extra packages", function()
+        local ctx = create_dummy_context()
+        installer.exec_in_context(ctx, function()
+            pnpm.install("my-package", "1.0.0", {
+                extra_packages = { "extra-package" },
+            })
+        end)
+
+        assert.spy(ctx.spawn.pnpm).was_called(1)
+        assert.spy(ctx.spawn.pnpm).was_called_with {
+            "add",
+            "my-package@1.0.0",
+            { "extra-package" },
+        }
+    end)
+end)