diff --git a/src/Microsoft.Health.Fhir.CosmosDb.Core/Configs/CosmosDataStoreConfiguration.cs b/src/Microsoft.Health.Fhir.CosmosDb.Core/Configs/CosmosDataStoreConfiguration.cs
index d0aab0076b..7c89638c3e 100644
--- a/src/Microsoft.Health.Fhir.CosmosDb.Core/Configs/CosmosDataStoreConfiguration.cs
+++ b/src/Microsoft.Health.Fhir.CosmosDb.Core/Configs/CosmosDataStoreConfiguration.cs
@@ -3,6 +3,7 @@
 // Licensed under the MIT License (MIT). See LICENSE in the repo root for license information.
 // -------------------------------------------------------------------------------------------------
 
+using System;
 using System.Collections.Generic;
 using Microsoft.Azure.Cosmos;
 
@@ -30,6 +31,24 @@ public class CosmosDataStoreConfiguration
 
         public ConnectionMode ConnectionMode { get; set; } = ConnectionMode.Direct;
 
+        // Default value is indefinate, recommended value is 20m - 24 hours. Setting to 1 hour.
+        public TimeSpan? IdleTcpConnectionTimeout { get; set; } = TimeSpan.FromHours(1);
+
+        // Default value is 5 seconds, recommended value is 1 second.
+        public TimeSpan? OpenTcpConnectionTimeout { get; set; } = TimeSpan.FromSeconds(1);
+
+        // Default value is 30, recommended value is 30. Leaving null to use the SDK default.
+        public int? MaxRequestsPerTcpConnection { get; set; }
+
+        // Default value is 65535, recommended value is 65535. Leaving null to use the SDK default.
+        public int? MaxTcpConnectionsPerEndpoint { get; set; }
+
+        // Default value is PortReuseMode.ReuseUnicastPort, recommended value is PortReuseMode.ReuseUnicastPort. Leaving null to use the SDK default.
+        public PortReuseMode? PortReuseMode { get; set; }
+
+        // Default value is true, recommended value is true. Leaving null to use the SDK default.
+        public bool EnableTcpConnectionEndpointRediscovery { get; set; }
+
         public ConsistencyLevel? DefaultConsistencyLevel { get; set; }
 
         [System.Diagnostics.CodeAnalysis.SuppressMessage("Usage", "CA2227:Collection properties should be read only", Justification = "This is a configuration class")]
diff --git a/src/Microsoft.Health.Fhir.CosmosDb/Features/Storage/FhirCosmosClientInitializer.cs b/src/Microsoft.Health.Fhir.CosmosDb/Features/Storage/FhirCosmosClientInitializer.cs
index edd3458885..1cf92bfce2 100644
--- a/src/Microsoft.Health.Fhir.CosmosDb/Features/Storage/FhirCosmosClientInitializer.cs
+++ b/src/Microsoft.Health.Fhir.CosmosDb/Features/Storage/FhirCosmosClientInitializer.cs
@@ -137,7 +137,13 @@ private CosmosClient CreateCosmosClientInternal(CosmosDataStoreConfiguration con
             }
             else
             {
-                builder.WithConnectionModeDirect(enableTcpConnectionEndpointRediscovery: true);
+                builder.WithConnectionModeDirect(
+                    idleTcpConnectionTimeout: configuration.IdleTcpConnectionTimeout,
+                    openTcpConnectionTimeout: configuration.OpenTcpConnectionTimeout,
+                    maxRequestsPerTcpConnection: configuration.MaxRequestsPerTcpConnection,
+                    maxTcpConnectionsPerEndpoint: configuration.MaxTcpConnectionsPerEndpoint,
+                    portReuseMode: configuration.PortReuseMode,
+                    enableTcpConnectionEndpointRediscovery: configuration.EnableTcpConnectionEndpointRediscovery);
             }
 
             builder