diff --git a/src/compiler/types.ts b/src/compiler/types.ts
index f505da17dd1a3..caaad5fb9ece0 100644
--- a/src/compiler/types.ts
+++ b/src/compiler/types.ts
@@ -8990,6 +8990,7 @@ namespace ts {
         readonly includeInlayFunctionLikeReturnTypeHints?: boolean;
         readonly includeInlayEnumMemberValueHints?: boolean;
         readonly allowRenameOfImportPath?: boolean;
+        readonly autoImportFileExcludePatterns?: string[];
     }
 
     /** Represents a bigint literal value without requiring bigint support */
diff --git a/src/server/protocol.ts b/src/server/protocol.ts
index 623699de435d6..e78d2262b5bca 100644
--- a/src/server/protocol.ts
+++ b/src/server/protocol.ts
@@ -3469,6 +3469,7 @@ namespace ts.server.protocol {
         readonly includeInlayPropertyDeclarationTypeHints?: boolean;
         readonly includeInlayFunctionLikeReturnTypeHints?: boolean;
         readonly includeInlayEnumMemberValueHints?: boolean;
+        readonly autoImportFileExcludePatterns?: string[];
     }
 
     export interface CompilerOptions {
diff --git a/src/services/codefixes/importFixes.ts b/src/services/codefixes/importFixes.ts
index d1ea8927fc18a..1507689f6103c 100644
--- a/src/services/codefixes/importFixes.ts
+++ b/src/services/codefixes/importFixes.ts
@@ -413,7 +413,7 @@ namespace ts.codefix {
             return createModuleSpecifierResolutionHost(isFromPackageJson ? host.getPackageJsonAutoImportProvider!()! : program, host);
         });
 
-        forEachExternalModuleToImportFrom(program, host, useAutoImportProvider, (moduleSymbol, moduleFile, program, isFromPackageJson) => {
+        forEachExternalModuleToImportFrom(program, host, preferences, useAutoImportProvider, (moduleSymbol, moduleFile, program, isFromPackageJson) => {
             const checker = program.getTypeChecker();
             // Don't import from a re-export when looking "up" like to `./index` or `../index`.
             if (moduleFile && moduleSymbol !== exportingModuleSymbol && startsWith(importingFile.fileName, getDirectoryPath(moduleFile.fileName))) {
@@ -979,7 +979,7 @@ namespace ts.codefix {
                 originalSymbolToExportInfos.add(getUniqueSymbolId(exportedSymbol, checker).toString(), { symbol: exportedSymbol, moduleSymbol, moduleFileName: toFile?.fileName, exportKind, targetFlags: skipAlias(exportedSymbol, checker).flags, isFromPackageJson });
             }
         }
-        forEachExternalModuleToImportFrom(program, host, useAutoImportProvider, (moduleSymbol, sourceFile, program, isFromPackageJson) => {
+        forEachExternalModuleToImportFrom(program, host, preferences, useAutoImportProvider, (moduleSymbol, sourceFile, program, isFromPackageJson) => {
             const checker = program.getTypeChecker();
             cancellationToken.throwIfCancellationRequested();
 
diff --git a/src/services/completions.ts b/src/services/completions.ts
index 9e5ae92726972..5d20343fff45e 100644
--- a/src/services/completions.ts
+++ b/src/services/completions.ts
@@ -366,7 +366,7 @@ namespace ts.Completions {
         if (!previousResponse) return undefined;
 
         const lowerCaseTokenText = location.text.toLowerCase();
-        const exportMap = getExportInfoMap(file, host, program, cancellationToken);
+        const exportMap = getExportInfoMap(file, host, program, preferences, cancellationToken);
         const newEntries = resolvingModuleSpecifiers(
             "continuePreviousIncompleteResponse",
             host,
@@ -2725,7 +2725,7 @@ namespace ts.Completions {
                 "";
 
             const moduleSpecifierCache = host.getModuleSpecifierCache?.();
-            const exportInfo = getExportInfoMap(sourceFile, host, program, cancellationToken);
+            const exportInfo = getExportInfoMap(sourceFile, host, program, preferences, cancellationToken);
             const packageJsonAutoImportProvider = host.getPackageJsonAutoImportProvider?.();
             const packageJsonFilter = detailsEntryId ? undefined : createPackageJsonImportFilter(sourceFile, preferences, host);
             resolvingModuleSpecifiers(
diff --git a/src/services/exportInfoMap.ts b/src/services/exportInfoMap.ts
index e8b52d48122ab..964079a8604fe 100644
--- a/src/services/exportInfoMap.ts
+++ b/src/services/exportInfoMap.ts
@@ -336,32 +336,42 @@ namespace ts {
     export function forEachExternalModuleToImportFrom(
         program: Program,
         host: LanguageServiceHost,
+        preferences: UserPreferences,
         useAutoImportProvider: boolean,
         cb: (module: Symbol, moduleFile: SourceFile | undefined, program: Program, isFromPackageJson: boolean) => void,
     ) {
-        forEachExternalModule(program.getTypeChecker(), program.getSourceFiles(), (module, file) => cb(module, file, program, /*isFromPackageJson*/ false));
+        const useCaseSensitiveFileNames = hostUsesCaseSensitiveFileNames(host);
+        const excludePatterns = preferences.autoImportFileExcludePatterns && mapDefined(preferences.autoImportFileExcludePatterns, spec => {
+            // The client is expected to send rooted path specs since we don't know
+            // what directory a relative path is relative to.
+            const pattern = getPatternFromSpec(spec, "", "exclude");
+            return pattern ? getRegexFromPattern(pattern, useCaseSensitiveFileNames) : undefined;
+        });
+
+        forEachExternalModule(program.getTypeChecker(), program.getSourceFiles(), excludePatterns, (module, file) => cb(module, file, program, /*isFromPackageJson*/ false));
         const autoImportProvider = useAutoImportProvider && host.getPackageJsonAutoImportProvider?.();
         if (autoImportProvider) {
             const start = timestamp();
-            forEachExternalModule(autoImportProvider.getTypeChecker(), autoImportProvider.getSourceFiles(), (module, file) => cb(module, file, autoImportProvider, /*isFromPackageJson*/ true));
+            forEachExternalModule(autoImportProvider.getTypeChecker(), autoImportProvider.getSourceFiles(), excludePatterns, (module, file) => cb(module, file, autoImportProvider, /*isFromPackageJson*/ true));
             host.log?.(`forEachExternalModuleToImportFrom autoImportProvider: ${timestamp() - start}`);
         }
     }
 
-    function forEachExternalModule(checker: TypeChecker, allSourceFiles: readonly SourceFile[], cb: (module: Symbol, sourceFile: SourceFile | undefined) => void) {
+    function forEachExternalModule(checker: TypeChecker, allSourceFiles: readonly SourceFile[], excludePatterns: readonly RegExp[] | undefined, cb: (module: Symbol, sourceFile: SourceFile | undefined) => void) {
+        const isExcluded = (fileName: string) => excludePatterns?.some(p => p.test(fileName));
         for (const ambient of checker.getAmbientModules()) {
-            if (!stringContains(ambient.name, "*")) {
+            if (!stringContains(ambient.name, "*") && !(excludePatterns && ambient.declarations?.every(d => isExcluded(d.getSourceFile().fileName)))) {
                 cb(ambient, /*sourceFile*/ undefined);
             }
         }
         for (const sourceFile of allSourceFiles) {
-            if (isExternalOrCommonJsModule(sourceFile)) {
+            if (isExternalOrCommonJsModule(sourceFile) && !isExcluded(sourceFile.fileName)) {
                 cb(checker.getMergedSymbol(sourceFile.symbol), sourceFile);
             }
         }
     }
 
-    export function getExportInfoMap(importingFile: SourceFile, host: LanguageServiceHost, program: Program, cancellationToken: CancellationToken | undefined): ExportInfoMap {
+    export function getExportInfoMap(importingFile: SourceFile, host: LanguageServiceHost, program: Program, preferences: UserPreferences, cancellationToken: CancellationToken | undefined): ExportInfoMap {
         const start = timestamp();
         // Pulling the AutoImportProvider project will trigger its updateGraph if pending,
         // which will invalidate the export map cache if things change, so pull it before
@@ -382,7 +392,7 @@ namespace ts {
         const compilerOptions = program.getCompilerOptions();
         let moduleCount = 0;
         try {
-            forEachExternalModuleToImportFrom(program, host, /*useAutoImportProvider*/ true, (moduleSymbol, moduleFile, program, isFromPackageJson) => {
+            forEachExternalModuleToImportFrom(program, host, preferences, /*useAutoImportProvider*/ true, (moduleSymbol, moduleFile, program, isFromPackageJson) => {
                 if (++moduleCount % 100 === 0) cancellationToken?.throwIfCancellationRequested();
                 const seenExports = new Map<__String, true>();
                 const checker = program.getTypeChecker();
diff --git a/tests/baselines/reference/api/tsserverlibrary.d.ts b/tests/baselines/reference/api/tsserverlibrary.d.ts
index 264708cf29fb9..fb15ec4f0113b 100644
--- a/tests/baselines/reference/api/tsserverlibrary.d.ts
+++ b/tests/baselines/reference/api/tsserverlibrary.d.ts
@@ -4138,6 +4138,7 @@ declare namespace ts {
         readonly includeInlayFunctionLikeReturnTypeHints?: boolean;
         readonly includeInlayEnumMemberValueHints?: boolean;
         readonly allowRenameOfImportPath?: boolean;
+        readonly autoImportFileExcludePatterns?: string[];
     }
     /** Represents a bigint literal value without requiring bigint support */
     export interface PseudoBigInt {
@@ -9769,6 +9770,7 @@ declare namespace ts.server.protocol {
         readonly includeInlayPropertyDeclarationTypeHints?: boolean;
         readonly includeInlayFunctionLikeReturnTypeHints?: boolean;
         readonly includeInlayEnumMemberValueHints?: boolean;
+        readonly autoImportFileExcludePatterns?: string[];
     }
     interface CompilerOptions {
         allowJs?: boolean;
diff --git a/tests/baselines/reference/api/typescript.d.ts b/tests/baselines/reference/api/typescript.d.ts
index c8cf181dff4ac..ed87f7ef8913b 100644
--- a/tests/baselines/reference/api/typescript.d.ts
+++ b/tests/baselines/reference/api/typescript.d.ts
@@ -4138,6 +4138,7 @@ declare namespace ts {
         readonly includeInlayFunctionLikeReturnTypeHints?: boolean;
         readonly includeInlayEnumMemberValueHints?: boolean;
         readonly allowRenameOfImportPath?: boolean;
+        readonly autoImportFileExcludePatterns?: string[];
     }
     /** Represents a bigint literal value without requiring bigint support */
     export interface PseudoBigInt {
diff --git a/tests/cases/fourslash/autoImportFileExcludePatterns1.ts b/tests/cases/fourslash/autoImportFileExcludePatterns1.ts
new file mode 100644
index 0000000000000..d4e7cb65cde88
--- /dev/null
+++ b/tests/cases/fourslash/autoImportFileExcludePatterns1.ts
@@ -0,0 +1,22 @@
+/// <reference path="fourslash.ts"/>
+
+// @module: commonjs
+
+// @Filename: /project/node_modules/aws-sdk/clients/s3.d.ts
+//// export declare class S3 {}
+
+// @Filename: /project/index.ts
+//// S3/**/
+
+const autoImportFileExcludePatterns = ["/**/node_modules/aws-sdk"];
+
+verify.completions({
+  marker: "",
+  excludes: "S3",
+  preferences: {
+    includeCompletionsForModuleExports: true,
+    autoImportFileExcludePatterns,
+  }
+});
+
+verify.importFixAtPosition([], /*errorCode*/ undefined, { autoImportFileExcludePatterns });
diff --git a/tests/cases/fourslash/autoImportFileExcludePatterns2.ts b/tests/cases/fourslash/autoImportFileExcludePatterns2.ts
new file mode 100644
index 0000000000000..8c5296189a2cd
--- /dev/null
+++ b/tests/cases/fourslash/autoImportFileExcludePatterns2.ts
@@ -0,0 +1,39 @@
+/// <reference path="fourslash.ts" />
+
+// @Filename: /lib/components/button/Button.ts
+//// export function Button() {}
+
+// @Filename: /lib/components/button/index.ts
+//// export * from "./Button";
+
+// @Filename: /lib/components/index.ts
+//// export * from "./button";
+
+// @Filename: /lib/main.ts
+//// export { Button } from "./components";
+
+// @Filename: /lib/index.ts
+//// export * from "./main";
+
+// @Filename: /i-hate-index-files.ts
+//// Button/**/
+
+verify.completions({
+  marker: "",
+  exact: completion.globalsPlus([{
+    name: "Button",
+    source: "./lib/main",
+    sourceDisplay: "./lib/main",
+    hasAction: true,
+    sortText: completion.SortText.AutoImportSuggestions,
+  }]),
+  preferences: {
+    allowIncompleteCompletions: true,
+    includeCompletionsForModuleExports: true,
+    autoImportFileExcludePatterns: ["/**/index.*"],
+  },
+});
+
+verify.importFixModuleSpecifiers("",
+  ["./lib/main", "./lib/components/button/Button"],
+  { autoImportFileExcludePatterns: ["/**/index.*"] });
diff --git a/tests/cases/fourslash/autoImportFileExcludePatterns3.ts b/tests/cases/fourslash/autoImportFileExcludePatterns3.ts
new file mode 100644
index 0000000000000..8f8ff5d4a1ed7
--- /dev/null
+++ b/tests/cases/fourslash/autoImportFileExcludePatterns3.ts
@@ -0,0 +1,52 @@
+/// <reference path="fourslash.ts" />
+
+// @module: commonjs
+
+// @Filename: /ambient1.d.ts
+//// declare module "foo" {
+////    export const x = 1;
+//// }
+
+// @Filename: /ambient2.d.ts
+//// declare module "foo" {
+////    export const y = 2;
+//// }
+
+// @Filename: /index.ts
+//// /**/
+
+verify.completions({
+  marker: "",
+  exact: completion.globalsPlus([{
+    // We don't look at what file each individual export came from; we
+    // only include or exclude modules wholesale, so excluding part of
+    // an ambient module or a module augmentation isn't supported.
+    name: "x",
+    source: "foo",
+    sourceDisplay: "foo",
+    hasAction: true,
+    sortText: completion.SortText.AutoImportSuggestions,
+  }, {
+    name: "y",
+    source: "foo",
+    sourceDisplay: "foo",
+    hasAction: true,
+    sortText: completion.SortText.AutoImportSuggestions,
+  }]),
+  preferences: {
+    allowIncompleteCompletions: true,
+    includeCompletionsForModuleExports: true,
+    autoImportFileExcludePatterns: ["/**/ambient1.d.ts"],
+  }
+});
+
+// Here, *every* file that declared "foo" is excluded.
+verify.completions({
+  marker: "",
+  exact: completion.globals,
+  preferences: {
+    allowIncompleteCompletions: true,
+    includeCompletionsForModuleExports: true,
+    autoImportFileExcludePatterns: ["/**/ambient*"],
+  }
+});
diff --git a/tests/cases/fourslash/fourslash.ts b/tests/cases/fourslash/fourslash.ts
index 7f66f77644cb9..a6c1804affb4a 100644
--- a/tests/cases/fourslash/fourslash.ts
+++ b/tests/cases/fourslash/fourslash.ts
@@ -662,6 +662,7 @@ declare namespace FourSlashInterface {
         readonly jsxAttributeCompletionStyle?: "auto" | "braces" | "none";
         readonly providePrefixAndSuffixTextForRename?: boolean;
         readonly allowRenameOfImportPath?: boolean;
+        readonly autoImportFileExcludePatterns?: readonly string[];
     }
     interface InlayHintsOptions extends UserPreferences {
         readonly includeInlayParameterNameHints?: "none" | "literals" | "all";
diff --git a/tests/cases/fourslash/server/autoImportFileExcludePatterns1.ts b/tests/cases/fourslash/server/autoImportFileExcludePatterns1.ts
new file mode 100644
index 0000000000000..2b2a7c9b9632f
--- /dev/null
+++ b/tests/cases/fourslash/server/autoImportFileExcludePatterns1.ts
@@ -0,0 +1,31 @@
+/// <reference path="../fourslash.ts"/>
+
+// @module: commonjs
+
+// @Filename: /project/node_modules/aws-sdk/package.json
+//// { "name": "aws-sdk", "version": "2.0.0", "main": "index.js" }
+
+// @Filename: /project/node_modules/aws-sdk/index.d.ts
+//// export * from "./clients/s3";
+
+// @Filename: /project/node_modules/aws-sdk/clients/s3.d.ts
+//// export declare class S3 {}
+
+// @Filename: /project/package.json
+//// { "dependencies": "aws-sdk" }
+
+// @Filename: /project/index.ts
+//// S3/**/
+
+const autoImportFileExcludePatterns = ["/**/node_modules/aws-sdk"];
+
+verify.completions({
+  marker: "",
+  excludes: "S3",
+  preferences: {
+    includeCompletionsForModuleExports: true,
+    autoImportFileExcludePatterns,
+  }
+});
+
+verify.importFixAtPosition([], /*errorCode*/ undefined, { autoImportFileExcludePatterns });