diff --git a/packages/deno/src/index.ts b/packages/deno/src/index.ts
index e6fdde530c81..f4eae76c587a 100644
--- a/packages/deno/src/index.ts
+++ b/packages/deno/src/index.ts
@@ -96,6 +96,8 @@ export {
   metrics,
   logger,
   consoleLoggingIntegration,
+  patchExpressModule,
+  setupExpressErrorHandler,
 } from '@sentry/core';
 
 export { DenoClient } from './client';
diff --git a/packages/deno/src/integrations/deno-serve.ts b/packages/deno/src/integrations/deno-serve.ts
index adb4d39a74d0..7faa44600039 100644
--- a/packages/deno/src/integrations/deno-serve.ts
+++ b/packages/deno/src/integrations/deno-serve.ts
@@ -1,6 +1,5 @@
 import type { IntegrationFn } from '@sentry/core';
 import { defineIntegration } from '@sentry/core';
-import { setAsyncLocalStorageAsyncContextStrategy } from '../async';
 import type { RequestHandlerWrapperOptions } from '../wrap-deno-request-handler';
 import { wrapDenoRequestHandler } from '../wrap-deno-request-handler';
 
@@ -48,7 +47,6 @@ const _denoServeIntegration = (() => {
   return {
     name: INTEGRATION_NAME,
     setupOnce() {
-      setAsyncLocalStorageAsyncContextStrategy();
       Deno.serve = new Proxy(Deno.serve, {
         apply(target, thisArg, args: ServeParams) {
           if (isSimpleHandler(args)) {
diff --git a/packages/deno/src/sdk.ts b/packages/deno/src/sdk.ts
index a40055002f57..674fb346710d 100644
--- a/packages/deno/src/sdk.ts
+++ b/packages/deno/src/sdk.ts
@@ -21,6 +21,7 @@ import { normalizePathsIntegration } from './integrations/normalizepaths';
 import { setupOpenTelemetryTracer } from './opentelemetry/tracer';
 import { makeFetchTransport } from './transports';
 import type { DenoOptions } from './types';
+import { setAsyncLocalStorageAsyncContextStrategy } from './async';
 
 /** Get the default integrations for the Deno SDK. */
 export function getDefaultIntegrations(_options: Options): Integration[] {
@@ -110,5 +111,7 @@ export function init(options: DenoOptions = {}): Client {
     setupOpenTelemetryTracer();
   }
 
+  setAsyncLocalStorageAsyncContextStrategy();
+
   return client;
 }
diff --git a/packages/deno/test/express.test.ts b/packages/deno/test/express.test.ts
new file mode 100644
index 000000000000..b762577744f5
--- /dev/null
+++ b/packages/deno/test/express.test.ts
@@ -0,0 +1,156 @@
+// <reference lib="deno.ns" />
+// @ts-types="npm:@types/express@4.17.21"
+
+import type { ErrorEvent, TransactionEvent } from '@sentry/core';
+import * as Sentry from '../build/esm/index.js';
+import { assertEquals, assertNotEquals } from 'https://deno.land/std@0.212.0/assert/mod.ts';
+
+const PORT = Number(process.env.PORT || 15443);
+
+// express only works on deno using node:http, and we have to manually
+// start a span in order to get it to create child spans for routes.
+import { createServer } from 'node:http';
+import type { Server } from 'node:http';
+import * as express from 'express';
+
+const transactionEvents: TransactionEvent[] = [];
+const errorEvents: ErrorEvent[] = [];
+
+Sentry.init({
+  dsn: 'https://username@domain/123',
+  tracesSampleRate: 1,
+  beforeSendTransaction: (event: TransactionEvent) => {
+    transactionEvents.push(event);
+    return null;
+  },
+  beforeSend: (event: ErrorEvent) => {
+    errorEvents.push(event);
+    return null;
+  },
+});
+Sentry.patchExpressModule({ express });
+
+const app = (express as unknown as { default: typeof express }).default();
+let server: Server;
+Deno.test('verify express server behavior', async () => {
+  async function main() {
+    app.use(async (_, res, next) => {
+      res.setHeader('content-type', 'text/html');
+      res.setHeader('connection', 'close');
+      // simulate doing some work so that the requests overlap
+      await new Promise(res => setTimeout(res, 50));
+      next();
+    });
+
+    app.get('/user/:user/error/:error', (req, res) => {
+      Sentry.captureMessage(`Error for user ${req.params.user}: ${req.params.error}`);
+      const userId = req.params.user || 'unknown';
+      Sentry.setUser({ id: userId });
+      Sentry.setTag('request.id', userId || 'unknown');
+      res.send(`error ${req.params.error} for user ${req.params.user}`);
+    });
+    app.get('/user/:user', (req, res) => {
+      const userId = req.params.user || 'unknown';
+      Sentry.setUser({ id: userId });
+      Sentry.setTag('request.id', userId || 'unknown');
+      res.setHeader('connection', 'close');
+      res.send(`Hello, ${req.params.user}`);
+    });
+
+    let onListen: ((_: unknown) => void) | undefined = undefined;
+    const p = new Promise(resolve => (onListen = resolve));
+    server = createServer((req, res) => {
+      // TODO: this should be done with a node:http integration
+      Sentry.withIsolationScope(async scope => {
+        scope.setClient(Sentry.getClient());
+        return Sentry.continueTrace(
+          {
+            sentryTrace: String(req.headers['sentry-trace'] || ''),
+            baggage: req.headers.baggage?.toString(),
+          },
+          () => {
+            Sentry.startSpan(
+              {
+                name: 'http.server',
+              },
+              async () => {
+                app(req, res);
+                return new Promise(resolve => res.on('finish', resolve));
+              },
+            );
+          },
+        );
+      });
+    }).listen(PORT, onListen);
+    await p;
+  }
+
+  let responses: [Response, Response, Response];
+  let responseText: [string, string, string];
+
+  await main();
+
+  responses = await Promise.all([
+    fetch(`http://localhost:15443/user/user1/error/true`),
+    fetch(`http://localhost:15443/user/user2`),
+    fetch(`http://localhost:15443/user/user3/error/true`),
+  ]);
+  responseText = await Promise.all([responses[0].text(), responses[1].text(), responses[2].text()]);
+  server.close();
+
+  const expectText = ['error true for user user1', 'Hello, user2', 'error true for user user3'];
+  assertEquals(responseText[0], expectText[0]);
+  assertEquals(responseText[1], expectText[1]);
+  assertEquals(responseText[2], expectText[2]);
+
+  assertEquals(transactionEvents.length, 3);
+  assertEquals(errorEvents.length, 2);
+  // verify that each transaction has expected spans, and that each is separate
+  const seen: string[] = [];
+  for (const tx of transactionEvents) {
+    if (!tx.contexts) {
+      throw new Error('no context for transaction!');
+    }
+    const { trace } = tx.contexts;
+    if (!trace) {
+      throw new Error('no trace in transaction');
+    }
+    assertEquals(trace.parent_span_id, undefined);
+    const { span_id, trace_id } = trace;
+    for (const s of seen) {
+      assertNotEquals(trace_id, s);
+    }
+    seen.push(trace_id);
+    assertNotEquals(span_id, undefined);
+    if (!Array.isArray(tx.spans)) {
+      throw new Error('no spans in transaction');
+    }
+    const results: { description: string; op: string }[] = [];
+    let whichRoute: string = '';
+    for (const span of tx.spans) {
+      const { op, description, origin, parent_span_id } = span;
+      assertEquals(parent_span_id, span_id);
+      assertEquals(span.trace_id, trace_id);
+      assertEquals(origin, 'auto.http.express');
+      assertEquals(typeof op, 'string');
+      assertEquals(typeof description, 'string');
+      results.push({ op, description } as { op: string; description: string });
+      if (op === 'request_handler.express') whichRoute = description as string;
+    }
+    const expect = [
+      { op: 'middleware.express', description: 'query' },
+      { op: 'middleware.express', description: 'expressInit' },
+      { op: 'middleware.express', description: '<anonymous>' },
+      { op: 'request_handler.express', description: whichRoute },
+    ];
+    assertEquals(results.length, expect.length);
+    for (let i = 0; i < expect.length; i++) {
+      const e = expect[i];
+      const t = results[i];
+      if (!e) throw new Error('got unexpected result');
+      if (!t) throw new Error('failed to get expected result');
+      assertEquals(t.op, e.op);
+      assertEquals(t.description, e.description);
+    }
+  }
+});