diff --git a/Extension/src/LanguageServer/client.ts b/Extension/src/LanguageServer/client.ts
index 22ccc7d96..98b473775 100644
--- a/Extension/src/LanguageServer/client.ts
+++ b/Extension/src/LanguageServer/client.ts
@@ -55,6 +55,7 @@ import { CustomConfigurationProvider1, getCustomConfigProviders, isSameProviderE
 import { DataBinding } from './dataBinding';
 import { cachedEditorConfigSettings, getEditorConfigSettings } from './editorConfig';
 import { CppSourceStr, clients, configPrefix, initializeIntervalTimer, isWritingCrashCallStack, updateLanguageConfigurations, usesCrashHandler, watchForCrashes } from './extension';
+import { IncludeCleanupPreferences, getIncludeCleanupPreferences } from './includeCleanupEditorConfig';
 import { InactiveRegion, InactiveRegionStore, getInactiveRegionStartLines } from './inactiveRegions';
 import { LanguageClient } from './languageClient';
 import { LocalizeStringParams, getLocaleId, getLocalizedString } from './localization';
@@ -507,6 +508,7 @@ interface TagParseStatus {
 interface VisibleEditorInfo {
     visibleRanges: Range[];
     originalEncoding: string;
+    includeCleanupPreferences: IncludeCleanupPreferences;
 }
 
 interface DidChangeVisibleTextEditorsParams {
@@ -1952,9 +1954,11 @@ export class DefaultClient implements Client {
             // First, we just concat all ranges for the same file.
             const uri: string = editor.document.uri.toString();
             if (!visibileEditorInfo[uri]) {
+                const editorConfigSettings: any = getEditorConfigSettings(editor.document.uri.fsPath);
                 visibileEditorInfo[uri] = {
                     visibleRanges: [],
-                    originalEncoding: editor.document.encoding
+                    originalEncoding: editor.document.encoding,
+                    includeCleanupPreferences: getIncludeCleanupPreferences(editorConfigSettings)
                 };
             }
             visibileEditorInfo[uri].visibleRanges = visibileEditorInfo[uri].visibleRanges.concat(editor.visibleRanges.map(makeLspRange));
@@ -2713,6 +2717,15 @@ export class DefaultClient implements Client {
 
     private associations_for_did_change?: Set<string>;
 
+    private refreshEditorConfigSettings(): void {
+        cachedEditorConfigSettings.clear();
+        cachedEditorConfigLookups.clear();
+        this.updateActiveDocumentTextOptions();
+
+        const cppEditors: vscode.TextEditor[] = vscode.window.visibleTextEditors.filter(editor => util.isCpp(editor.document));
+        void this.onDidChangeVisibleTextEditors(cppEditors).catch(logAndReturn.undefined);
+    }
+
     /**
      * listen for file created/deleted events under the ${workspaceFolder} folder
      */
@@ -2733,9 +2746,7 @@ export class DefaultClient implements Client {
                 }
                 const fileName: string = path.basename(uri.fsPath).toLowerCase();
                 if (fileName === ".editorconfig") {
-                    cachedEditorConfigSettings.clear();
-                    cachedEditorConfigLookups.clear();
-                    this.updateActiveDocumentTextOptions();
+                    this.refreshEditorConfigSettings();
                 }
                 if (fileName === ".clang-format" || fileName === "_clang-format") {
                     cachedEditorConfigLookups.clear();
@@ -2761,9 +2772,7 @@ export class DefaultClient implements Client {
                 const dotIndex: number = uri.fsPath.lastIndexOf('.');
                 const fileName: string = path.basename(uri.fsPath).toLowerCase();
                 if (fileName === ".editorconfig") {
-                    cachedEditorConfigSettings.clear();
-                    cachedEditorConfigLookups.clear();
-                    this.updateActiveDocumentTextOptions();
+                    this.refreshEditorConfigSettings();
                 }
                 const ext: string | undefined = dotIndex !== -1 ? uri.fsPath.substring(dotIndex + 1) : undefined;
                 const isTrackedFile: boolean = hasNativeFileTypeMappings()
@@ -2788,8 +2797,7 @@ export class DefaultClient implements Client {
                 }
                 const fileName: string = path.basename(uri.fsPath).toLowerCase();
                 if (fileName === ".editorconfig") {
-                    cachedEditorConfigSettings.clear();
-                    cachedEditorConfigLookups.clear();
+                    this.refreshEditorConfigSettings();
                 }
                 if (fileName === ".clang-format" || fileName === "_clang-format") {
                     cachedEditorConfigLookups.clear();
diff --git a/Extension/src/LanguageServer/includeCleanupEditorConfig.ts b/Extension/src/LanguageServer/includeCleanupEditorConfig.ts
new file mode 100644
index 000000000..69cc3f31c
--- /dev/null
+++ b/Extension/src/LanguageServer/includeCleanupEditorConfig.ts
@@ -0,0 +1,23 @@
+export interface IncludeCleanupPreferences {
+    alternateFiles: string;
+    excludedFiles: string;
+    replacementFiles: string;
+    requiredFiles: string;
+}
+
+function getStringSetting(settings: any, key: string): string {
+    const value: unknown = settings?.[key];
+    if (typeof value !== 'string' || value.toLowerCase() === 'unset') {
+        return '';
+    }
+    return value;
+}
+
+export function getIncludeCleanupPreferences(settings: any): IncludeCleanupPreferences {
+    return {
+        alternateFiles: getStringSetting(settings, 'cpp_include_cleanup_alternate_files'),
+        excludedFiles: getStringSetting(settings, 'cpp_include_cleanup_excluded_files'),
+        replacementFiles: getStringSetting(settings, 'cpp_include_cleanup_replacement_files'),
+        requiredFiles: getStringSetting(settings, 'cpp_include_cleanup_required_files')
+    };
+}
diff --git a/Extension/test/unit/includeCleanupEditorConfig.test.ts b/Extension/test/unit/includeCleanupEditorConfig.test.ts
new file mode 100644
index 000000000..427c35e62
--- /dev/null
+++ b/Extension/test/unit/includeCleanupEditorConfig.test.ts
@@ -0,0 +1,32 @@
+import { deepStrictEqual } from 'assert';
+import { describe, it } from 'mocha';
+import { getIncludeCleanupPreferences } from '../../src/LanguageServer/includeCleanupEditorConfig';
+
+describe('Include Cleanup editorconfig settings', () => {
+    it('maps semantic preference strings', () => {
+        deepStrictEqual(getIncludeCleanupPreferences({
+            cpp_include_cleanup_alternate_files: 'umbrella.h:internal.h',
+            cpp_include_cleanup_excluded_files: 'generated.h',
+            cpp_include_cleanup_replacement_files: 'stdio.h:cstdio',
+            cpp_include_cleanup_required_files: 'atlwin.h:atlbase.h'
+        }), {
+            alternateFiles: 'umbrella.h:internal.h',
+            excludedFiles: 'generated.h',
+            replacementFiles: 'stdio.h:cstdio',
+            requiredFiles: 'atlwin.h:atlbase.h'
+        });
+    });
+
+    it('maps unset and non-string values to empty strings', () => {
+        deepStrictEqual(getIncludeCleanupPreferences({
+            cpp_include_cleanup_alternate_files: 'unset',
+            cpp_include_cleanup_excluded_files: true,
+            cpp_include_cleanup_replacement_files: 42
+        }), {
+            alternateFiles: '',
+            excludedFiles: '',
+            replacementFiles: '',
+            requiredFiles: ''
+        });
+    });
+});