diff --git a/packages/react-art/src/ReactARTHostConfig.js b/packages/react-art/src/ReactARTHostConfig.js
index e0e883c4b21b5..5ea20502ef574 100644
--- a/packages/react-art/src/ReactARTHostConfig.js
+++ b/packages/react-art/src/ReactARTHostConfig.js
@@ -488,7 +488,7 @@ export function makeClientIdInDEV(warnOnAccessInDEV: () => void): OpaqueIDType {
   throw new Error('Not yet implemented');
 }
 
-export function makeServerId(): OpaqueIDType {
+export function makeServerId(prefix: ?string, serverId: number): OpaqueIDType {
   throw new Error('Not yet implemented');
 }
 
diff --git a/packages/react-dom/src/__tests__/ReactDOMServerIntegrationHooks-test.internal.js b/packages/react-dom/src/__tests__/ReactDOMServerIntegrationHooks-test.internal.js
index a910b011f0507..a1929446e4e69 100644
--- a/packages/react-dom/src/__tests__/ReactDOMServerIntegrationHooks-test.internal.js
+++ b/packages/react-dom/src/__tests__/ReactDOMServerIntegrationHooks-test.internal.js
@@ -1008,6 +1008,91 @@ describe('ReactDOMServerHooks', () => {
         );
       });
 
+      it('useOpaqueIdentifier prefix works for server renderer and does not clash', async () => {
+        function ChildTwo({id}) {
+          return <div id={id}>Child Three</div>;
+        }
+        function App() {
+          const id = useOpaqueIdentifier();
+          const idTwo = useOpaqueIdentifier();
+
+          return (
+            <div>
+              <div aria-labelledby={id}>Chid One</div>
+              <ChildTwo id={id} />
+              <div aria-labelledby={idTwo}>Child Three</div>
+              <div id={idTwo}>Child Four</div>
+            </div>
+          );
+        }
+
+        const containerOne = document.createElement('div');
+        document.body.append(containerOne);
+
+        containerOne.innerHTML = ReactDOMServer.renderToString(<App />, {
+          prefix: 'one',
+        });
+
+        const containerTwo = document.createElement('div');
+        document.body.append(containerTwo);
+
+        containerTwo.innerHTML = ReactDOMServer.renderToString(<App />, {
+          prefix: 'two',
+        });
+
+        expect(document.body.children.length).toEqual(2);
+        const childOne = document.body.children[0];
+        const childTwo = document.body.children[1];
+
+        expect(
+          childOne.children[0].children[0].getAttribute('aria-labelledby'),
+        ).toEqual(childOne.children[0].children[1].getAttribute('id'));
+        expect(
+          childOne.children[0].children[2].getAttribute('aria-labelledby'),
+        ).toEqual(childOne.children[0].children[3].getAttribute('id'));
+
+        expect(
+          childOne.children[0].children[0].getAttribute('aria-labelledby'),
+        ).not.toEqual(
+          childOne.children[0].children[2].getAttribute('aria-labelledby'),
+        );
+
+        expect(
+          childOne.children[0].children[0]
+            .getAttribute('aria-labelledby')
+            .startsWith('one'),
+        ).toBe(true);
+        expect(
+          childOne.children[0].children[2]
+            .getAttribute('aria-labelledby')
+            .includes('one'),
+        ).toBe(true);
+
+        expect(
+          childTwo.children[0].children[0].getAttribute('aria-labelledby'),
+        ).toEqual(childTwo.children[0].children[1].getAttribute('id'));
+        expect(
+          childTwo.children[0].children[2].getAttribute('aria-labelledby'),
+        ).toEqual(childTwo.children[0].children[3].getAttribute('id'));
+
+        expect(
+          childTwo.children[0].children[0].getAttribute('aria-labelledby'),
+        ).not.toEqual(
+          childTwo.children[0].children[2].getAttribute('aria-labelledby'),
+        );
+
+        expect(
+          childTwo.children[0].children[0]
+            .getAttribute('aria-labelledby')
+            .startsWith('two'),
+        ).toBe(true);
+        expect(
+          childTwo.children[0].children[2]
+            .getAttribute('aria-labelledby')
+            .startsWith('two'),
+        ).toBe(true);
+      });
+
       it('useOpaqueIdentifier: IDs match when, after hydration, a new component that uses the ID is rendered', async () => {
         let _setShowDiv;
         function App() {
diff --git a/packages/react-dom/src/client/ReactDOMHostConfig.js b/packages/react-dom/src/client/ReactDOMHostConfig.js
index b8b0050de7a59..d9c5b6b391ddd 100644
--- a/packages/react-dom/src/client/ReactDOMHostConfig.js
+++ b/packages/react-dom/src/client/ReactDOMHostConfig.js
@@ -1174,9 +1174,8 @@ export function makeClientIdInDEV(warnOnAccessInDEV: () => void): OpaqueIDType {
   };
 }
 
-let serverId: number = 0;
-export function makeServerId(): OpaqueIDType {
-  return 'R:' + (serverId++).toString(36);
+export function makeServerId(prefix: ?string, serverId: number): OpaqueIDType {
+  return (prefix || '') + 'R:' + serverId.toString(36);
 }
 
 export function isOpaqueHydratingObject(value: mixed): boolean {
diff --git a/packages/react-dom/src/server/ReactDOMNodeStreamRenderer.js b/packages/react-dom/src/server/ReactDOMNodeStreamRenderer.js
index 22ccd73853990..0e76fc1b59256 100644
--- a/packages/react-dom/src/server/ReactDOMNodeStreamRenderer.js
+++ b/packages/react-dom/src/server/ReactDOMNodeStreamRenderer.js
@@ -4,6 +4,7 @@
  * This source code is licensed under the MIT license found in the
  * LICENSE file in the root directory of this source tree.
  */
+import type {PartialRendererOptions} from './ReactPartialRenderer';
 
 import {Readable} from 'stream';
 
@@ -36,8 +37,11 @@ class ReactMarkupReadableStream extends Readable {
  * server.
  * See https://reactjs.org/docs/react-dom-server.html#rendertonodestream
  */
-export function renderToNodeStream(element) {
-  return new ReactMarkupReadableStream(element, false);
+export function renderToNodeStream(
+  element,
+  options: PartialRendererOptions | void,
+) {
+  return new ReactMarkupReadableStream(element, false, options);
 }
 
 /**
@@ -45,6 +49,9 @@ export function renderToNodeStream(element) {
  * such as data-react-id that React uses internally.
  * See https://reactjs.org/docs/react-dom-server.html#rendertostaticnodestream
  */
-export function renderToStaticNodeStream(element) {
-  return new ReactMarkupReadableStream(element, true);
+export function renderToStaticNodeStream(
+  element,
+  options: PartialRendererOptions | void,
+) {
+  return new ReactMarkupReadableStream(element, true, options);
 }
diff --git a/packages/react-dom/src/server/ReactDOMStringRenderer.js b/packages/react-dom/src/server/ReactDOMStringRenderer.js
index 1afc65acd6d5c..d530fb628e356 100644
--- a/packages/react-dom/src/server/ReactDOMStringRenderer.js
+++ b/packages/react-dom/src/server/ReactDOMStringRenderer.js
@@ -5,6 +5,7 @@
  * LICENSE file in the root directory of this source tree.
  */
 
+import type {PartialRendererOptions} from './ReactPartialRenderer';
 import ReactPartialRenderer from './ReactPartialRenderer';
 
 /**
@@ -12,8 +13,11 @@ import ReactPartialRenderer from './ReactPartialRenderer';
  * server.
  * See https://reactjs.org/docs/react-dom-server.html#rendertostring
  */
-export function renderToString(element) {
-  const renderer = new ReactPartialRenderer(element, false);
+export function renderToString(
+  element,
+  options?: void | PartialRendererOptions,
+) {
+  const renderer = new ReactPartialRenderer(element, false, options);
   try {
     const markup = renderer.read(Infinity);
     return markup;
@@ -27,10 +31,13 @@ export function renderToString(element) {
  * such as data-react-id that React uses internally.
  * See https://reactjs.org/docs/react-dom-server.html#rendertostaticmarkup
  */
-export function renderToStaticMarkup(element) {
-  const renderer = new ReactPartialRenderer(element, true);
+export function renderToStaticMarkup(
+  element,
+  options?: void | PartialRendererOptions,
+) {
+  const renderer = new ReactPartialRenderer(element, true, options);
   try {
-    const markup = renderer.read(Infinity);
+    const markup = renderer.read(Infinity, options);
     return markup;
   } finally {
     renderer.destroy();
diff --git a/packages/react-dom/src/server/ReactPartialRenderer.js b/packages/react-dom/src/server/ReactPartialRenderer.js
index c1ff6d2bd35c4..0a12606e517d3 100644
--- a/packages/react-dom/src/server/ReactPartialRenderer.js
+++ b/packages/react-dom/src/server/ReactPartialRenderer.js
@@ -61,6 +61,10 @@ import {
   Dispatcher,
   currentThreadID,
   setCurrentThreadID,
+  currentUniqueID,
+  setCurrentUniqueID,
+  uniqueIDPrefix,
+  setCurrentUniqueIDPrefix,
 } from './ReactPartialRendererHooks';
 import {
   Namespaces,
@@ -78,6 +82,10 @@ import {validateProperties as validateARIAProperties} from '../shared/ReactDOMIn
 import {validateProperties as validateInputProperties} from '../shared/ReactDOMNullInputValuePropHook';
 import {validateProperties as validateUnknownProperties} from '../shared/ReactDOMUnknownPropertyHook';
 
+export type PartialRendererOptions = {
+  prefix?: string,
+};
+
 // Based on reading the React.Children implementation. TODO: type this somewhere?
 type ReactNode = string | number | ReactElement;
 type FlatReactChildren = Array<null | ReactNode>;
@@ -725,7 +733,14 @@ class ReactDOMServerRenderer {
   contextValueStack: Array<any>;
   contextProviderStack: ?Array<ReactProvider<any>>; // DEV-only
 
-  constructor(children: mixed, makeStaticMarkup: boolean) {
+  uniqueID: number;
+  prefix: string;
+
+  constructor(
+    children: mixed,
+    makeStaticMarkup: boolean,
+    options?: PartialRendererOptions | void,
+  ) {
     const flatChildren = flattenTopLevelChildren(children);
 
     const topFrame: Frame = {
@@ -753,6 +768,11 @@ class ReactDOMServerRenderer {
     this.contextIndex = -1;
     this.contextStack = [];
     this.contextValueStack = [];
+
+    // useOpaqueIdentifier ID
+    this.uniqueID = 0;
+    this.prefix = (options && options.prefix) || '';
+
     if (__DEV__) {
       this.contextProviderStack = [];
     }
@@ -838,6 +858,10 @@ class ReactDOMServerRenderer {
 
     const prevThreadID = currentThreadID;
     setCurrentThreadID(this.threadID);
+    const prevUniqueID = currentUniqueID;
+    setCurrentUniqueID(this.uniqueID);
+    const prevUniquePrefix = uniqueIDPrefix;
+    setCurrentUniqueIDPrefix(this.prefix);
     const prevDispatcher = ReactCurrentDispatcher.current;
     ReactCurrentDispatcher.current = Dispatcher;
     try {
@@ -935,6 +959,8 @@ class ReactDOMServerRenderer {
     } finally {
       ReactCurrentDispatcher.current = prevDispatcher;
       setCurrentThreadID(prevThreadID);
+      setCurrentUniqueID(prevUniqueID);
+      setCurrentUniqueIDPrefix(prevUniquePrefix);
     }
   }
 
diff --git a/packages/react-dom/src/server/ReactPartialRendererHooks.js b/packages/react-dom/src/server/ReactPartialRendererHooks.js
index fe5c11c4a9994..7ca8d770211f3 100644
--- a/packages/react-dom/src/server/ReactPartialRendererHooks.js
+++ b/packages/react-dom/src/server/ReactPartialRendererHooks.js
@@ -495,8 +495,19 @@ function useTransition(
   return [startTransition, false];
 }
 
+export let currentUniqueID: number = 0;
+export let uniqueIDPrefix: string = '';
+
+export function setCurrentUniqueIDPrefix(prefix: string) {
+  uniqueIDPrefix = prefix;
+}
+
+export function setCurrentUniqueID(id: number) {
+  currentUniqueID = id;
+}
+
 function useOpaqueIdentifier(): OpaqueIDType {
-  return makeServerId();
+  return makeServerId(uniqueIDPrefix, currentUniqueID++);
 }
 
 function useEvent(event: any): ReactDOMListenerMap {
diff --git a/packages/react-native-renderer/src/ReactFabricHostConfig.js b/packages/react-native-renderer/src/ReactFabricHostConfig.js
index 91aa98398114e..fbf830ee93f0d 100644
--- a/packages/react-native-renderer/src/ReactFabricHostConfig.js
+++ b/packages/react-native-renderer/src/ReactFabricHostConfig.js
@@ -505,7 +505,7 @@ export function makeClientIdInDEV(warnOnAccessInDEV: () => void): OpaqueIDType {
   throw new Error('Not yet implemented');
 }
 
-export function makeServerId(): OpaqueIDType {
+export function makeServerId(prefix: ?string, serverId: number): OpaqueIDType {
   throw new Error('Not yet implemented');
 }
 
diff --git a/packages/react-native-renderer/src/ReactNativeHostConfig.js b/packages/react-native-renderer/src/ReactNativeHostConfig.js
index a6ed4de72c392..bf81b81c6dc6f 100644
--- a/packages/react-native-renderer/src/ReactNativeHostConfig.js
+++ b/packages/react-native-renderer/src/ReactNativeHostConfig.js
@@ -554,7 +554,7 @@ export function makeClientIdInDEV(warnOnAccessInDEV: () => void): OpaqueIDType {
   throw new Error('Not yet implemented');
 }
 
-export function makeServerId(): OpaqueIDType {
+export function makeServerId(prefix: ?string, serverId: number): OpaqueIDType {
   throw new Error('Not yet implemented');
 }
 
diff --git a/packages/react-test-renderer/src/ReactTestHostConfig.js b/packages/react-test-renderer/src/ReactTestHostConfig.js
index c3eda48d2a4ea..3754a9339de59 100644
--- a/packages/react-test-renderer/src/ReactTestHostConfig.js
+++ b/packages/react-test-renderer/src/ReactTestHostConfig.js
@@ -407,9 +407,8 @@ export function makeClientIdInDEV(warnOnAccessInDEV: () => void): OpaqueIDType {
   };
 }
 
-let serverId: number = 0;
-export function makeServerId(): OpaqueIDType {
-  return 's_' + (serverId++).toString(36);
+export function makeServerId(prefix: ?string, serverId: number): OpaqueIDType {
+  return (prefix || '') + 's_' + serverId.toString(36);
 }
 
 export function isOpaqueHydratingObject(value: mixed): boolean {