diff --git a/modules/programs/vscode.nix b/modules/programs/vscode.nix
index 27faf39bc..414e74510 100644
--- a/modules/programs/vscode.nix
+++ b/modules/programs/vscode.nix
@@ -7,6 +7,7 @@ let
   cfg = config.programs.vscode;
 
   vscodePname = cfg.package.pname;
+  vscodeVersion = cfg.package.version;
 
   jsonFormat = pkgs.formats.json { };
 
@@ -34,6 +35,13 @@ let
   # TODO: On Darwin where are the extensions?
   extensionPath = ".${extensionDir}/extensions";
 
+  extensionJson = pkgs.vscode-utils.toExtensionJson cfg.extensions;
+  extensionJsonFile = pkgs.writeTextFile {
+    name = "extensions-json";
+    destination = "/share/vscode/extensions/extensions.json";
+    text = extensionJson;
+  };
+
   mergedUserSettings = cfg.userSettings
     // optionalAttrs (!cfg.enableUpdateCheck) { "update.mode" = "none"; }
     // optionalAttrs (!cfg.enableExtensionUpdateCheck) {
@@ -55,6 +63,7 @@ in {
       package = mkOption {
         type = types.package;
         default = pkgs.vscode;
+        defaultText = literalExpression "pkgs.vscode";
         example = literalExpression "pkgs.vscodium";
         description = ''
           Version of Visual Studio Code to install.
@@ -211,12 +220,26 @@ in {
           else
             builtins.attrNames (builtins.readDir (ext + "/${subDir}")));
       in if cfg.mutableExtensionsDir then
-        mkMerge (concatMap toPaths cfg.extensions)
+        mkMerge (concatMap toPaths cfg.extensions
+          ++ lib.optional (lib.versionAtLeast vscodeVersion "1.74.0") [{
+            # Whenever our immutable extensions.json changes, force VSCode to regenerate
+            # extensions.json with both mutable and immutable extensions.
+            "${extensionPath}/.extensions-immutable.json" = {
+              text = extensionJson;
+              onChange = ''
+                $DRY_RUN_CMD rm $VERBOSE_ARG -f ${extensionPath}/{extensions.json,.init-default-profile-extensions}
+                $VERBOSE_ECHO "Regenerating VSCode extensions.json"
+                $DRY_RUN_CMD ${getExe cfg.package} --list-extensions > /dev/null
+              '';
+            };
+          }])
       else {
         "${extensionPath}".source = let
           combinedExtensionsDrv = pkgs.buildEnv {
             name = "vscode-extensions";
-            paths = cfg.extensions;
+            paths = cfg.extensions
+              ++ lib.optional (lib.versionAtLeast vscodeVersion "1.74.0")
+              [ extensionJsonFile ];
           };
         in "${combinedExtensionsDrv}/${subDir}";
       }))