diff --git a/dev-packages/e2e-tests/test-applications/nuxt-3/sentry.server.config.ts b/dev-packages/e2e-tests/test-applications/nuxt-3/sentry.server.config.ts
index 729b2296c683..e04331934f99 100644
--- a/dev-packages/e2e-tests/test-applications/nuxt-3/sentry.server.config.ts
+++ b/dev-packages/e2e-tests/test-applications/nuxt-3/sentry.server.config.ts
@@ -5,4 +5,5 @@ Sentry.init({
   environment: 'qa', // dynamic sampling bias to keep transactions
   tracesSampleRate: 1.0, //  Capture 100% of the transactions
   tunnel: 'http://localhost:3031/', // proxy server
+  enableNitroErrorHandler: false, // Error handler is defined in server/plugins/customNitroErrorHandler.ts
 });
diff --git a/dev-packages/e2e-tests/test-applications/nuxt-3/server/plugins/customNitroErrorHandler.ts b/dev-packages/e2e-tests/test-applications/nuxt-3/server/plugins/customNitroErrorHandler.ts
new file mode 100644
index 000000000000..2d9258936169
--- /dev/null
+++ b/dev-packages/e2e-tests/test-applications/nuxt-3/server/plugins/customNitroErrorHandler.ts
@@ -0,0 +1,85 @@
+import { Context, GLOBAL_OBJ, dropUndefinedKeys, flush, logger, vercelWaitUntil } from '@sentry/core';
+import * as SentryNode from '@sentry/node';
+import { H3Error } from 'h3';
+import type { CapturedErrorContext } from 'nitropack';
+import { defineNitroPlugin } from '#imports';
+
+// Copy from SDK-internal error handler (nuxt/src/runtime/plugins/sentry.server.ts)
+export default defineNitroPlugin(nitroApp => {
+  nitroApp.hooks.hook('error', async (error, errorContext) => {
+    // Do not handle 404 and 422
+    if (error instanceof H3Error) {
+      // Do not report if status code is 3xx or 4xx
+      if (error.statusCode >= 300 && error.statusCode < 500) {
+        return;
+      }
+    }
+
+    const { method, path } = {
+      method: errorContext.event?._method ? errorContext.event._method : '',
+      path: errorContext.event?._path ? errorContext.event._path : null,
+    };
+
+    if (path) {
+      SentryNode.getCurrentScope().setTransactionName(`${method} ${path}`);
+    }
+
+    const structuredContext = extractErrorContext(errorContext);
+
+    SentryNode.captureException(error, {
+      captureContext: { contexts: { nuxt: structuredContext } },
+      mechanism: { handled: false },
+    });
+
+    await flushIfServerless();
+  });
+});
+
+function extractErrorContext(errorContext: CapturedErrorContext): Context {
+  const structuredContext: Context = {
+    method: undefined,
+    path: undefined,
+    tags: undefined,
+  };
+
+  if (errorContext) {
+    if (errorContext.event) {
+      structuredContext.method = errorContext.event._method || undefined;
+      structuredContext.path = errorContext.event._path || undefined;
+    }
+
+    if (Array.isArray(errorContext.tags)) {
+      structuredContext.tags = errorContext.tags || undefined;
+    }
+  }
+
+  return dropUndefinedKeys(structuredContext);
+}
+
+async function flushIfServerless(): Promise<void> {
+  const isServerless =
+    !!process.env.FUNCTIONS_WORKER_RUNTIME || // Azure Functions
+    !!process.env.LAMBDA_TASK_ROOT || // AWS Lambda
+    !!process.env.VERCEL ||
+    !!process.env.NETLIFY;
+
+  // @ts-expect-error This is not typed
+  if (GLOBAL_OBJ[Symbol.for('@vercel/request-context')]) {
+    vercelWaitUntil(flushWithTimeout());
+  } else if (isServerless) {
+    await flushWithTimeout();
+  }
+}
+
+async function flushWithTimeout(): Promise<void> {
+  const sentryClient = SentryNode.getClient();
+  const isDebug = sentryClient ? sentryClient.getOptions().debug : false;
+
+  try {
+    isDebug && logger.log('Flushing events...');
+    await flush(2000);
+    isDebug && logger.log('Done flushing events');
+  } catch (e) {
+    isDebug && logger.log('Error while flushing events:\n', e);
+  }
+}
diff --git a/packages/nuxt/src/common/types.ts b/packages/nuxt/src/common/types.ts
index 02e0b53bac7c..599b564f62a2 100644
--- a/packages/nuxt/src/common/types.ts
+++ b/packages/nuxt/src/common/types.ts
@@ -6,7 +6,20 @@ import type { init as initVue } from '@sentry/vue';
 // Omitting Vue 'app' as the Nuxt SDK will add the app instance in the client plugin (users do not have to provide this)
 // Adding `& object` helps TS with inferring that this is not `undefined` but an object type
 export type SentryNuxtClientOptions = Omit<Parameters<typeof initVue>[0] & object, 'app'>;
-export type SentryNuxtServerOptions = Parameters<typeof initNode>[0] & object;
+export type SentryNuxtServerOptions = Parameters<typeof initNode>[0] & {
+  /**
+   * Enables the Sentry error handler for the Nitro error hook.
+   *
+   * When enabled, exceptions are automatically sent to Sentry with additional data such as the transaction name and Nitro error context.
+   * It's recommended to keep this enabled unless you need to implement a custom error handler.
+   *
+   * If you need a custom implementation, disable this option and refer to the default handler as a reference:
+   * https://github.com/getsentry/sentry-javascript/blob/da8ba8d77a28b43da5014acc8dd98906d2180cc1/packages/nuxt/src/runtime/plugins/sentry.server.ts#L20-L46
+   *
+   * @default true
+   */
+  enableNitroErrorHandler?: boolean;
+};
 
 type SourceMapsOptions = {
   /**
diff --git a/packages/nuxt/src/runtime/plugins/sentry.server.ts b/packages/nuxt/src/runtime/plugins/sentry.server.ts
index 5d828775b62f..f65ac64b9982 100644
--- a/packages/nuxt/src/runtime/plugins/sentry.server.ts
+++ b/packages/nuxt/src/runtime/plugins/sentry.server.ts
@@ -1,14 +1,13 @@
 import {
   GLOBAL_OBJ,
   flush,
-  getClient,
   getDefaultIsolationScope,
   getIsolationScope,
   logger,
   vercelWaitUntil,
   withIsolationScope,
 } from '@sentry/core';
-import * as Sentry from '@sentry/node';
+import * as SentryNode from '@sentry/node';
 import { type EventHandler, H3Error } from 'h3';
 import { defineNitroPlugin } from 'nitropack/runtime';
 import type { NuxtRenderHTMLContext } from 'nuxt/app';
@@ -18,6 +17,17 @@ export default defineNitroPlugin(nitroApp => {
   nitroApp.h3App.handler = patchEventHandler(nitroApp.h3App.handler);
 
   nitroApp.hooks.hook('error', async (error, errorContext) => {
+    const sentryClient = SentryNode.getClient();
+    const sentryClientOptions = sentryClient?.getOptions();
+
+    if (
+      sentryClientOptions &&
+      'enableNitroErrorHandler' in sentryClientOptions &&
+      sentryClientOptions.enableNitroErrorHandler === false
+    ) {
+      return;
+    }
+
     // Do not handle 404 and 422
     if (error instanceof H3Error) {
       // Do not report if status code is 3xx or 4xx
@@ -32,12 +42,12 @@ export default defineNitroPlugin(nitroApp => {
     };
 
     if (path) {
-      Sentry.getCurrentScope().setTransactionName(`${method} ${path}`);
+      SentryNode.getCurrentScope().setTransactionName(`${method} ${path}`);
     }
 
     const structuredContext = extractErrorContext(errorContext);
 
-    Sentry.captureException(error, {
+    SentryNode.captureException(error, {
       captureContext: { contexts: { nuxt: structuredContext } },
       mechanism: { handled: false },
     });
@@ -67,7 +77,7 @@ async function flushIfServerless(): Promise<void> {
 }
 
 async function flushWithTimeout(): Promise<void> {
-  const sentryClient = getClient();
+  const sentryClient = SentryNode.getClient();
   const isDebug = sentryClient ? sentryClient.getOptions().debug : false;
 
   try {