diff --git a/src/Analyzers/CSharp/Analyzers/UseExpressionBodyForLambda/UseExpressionBodyForLambdaHelpers.cs b/src/Analyzers/CSharp/Analyzers/UseExpressionBodyForLambda/UseExpressionBodyForLambdaHelpers.cs
index bb2a81c2f53ba..f2ddccdc64584 100644
--- a/src/Analyzers/CSharp/Analyzers/UseExpressionBodyForLambda/UseExpressionBodyForLambdaHelpers.cs
+++ b/src/Analyzers/CSharp/Analyzers/UseExpressionBodyForLambda/UseExpressionBodyForLambdaHelpers.cs
@@ -3,6 +3,7 @@
 // See the LICENSE file in the project root for more information.
 
 using System.Diagnostics.CodeAnalysis;
+using System.Linq;
 using System.Threading;
 using Microsoft.CodeAnalysis.CodeStyle;
 using Microsoft.CodeAnalysis.CSharp.Extensions;
@@ -112,6 +113,33 @@ internal static bool TryConvertToExpressionBody(
     {
         var body = declaration.Body as BlockSyntax;
 
-        return body.TryConvertToExpressionBody(languageVersion, conversionPreference, cancellationToken, out expression, out _);
+        if (!body.TryConvertToExpressionBody(languageVersion, conversionPreference, cancellationToken, out expression, out var semicolonToken))
+            return false;
+
+        // If we have directives, we have something like:
+        //
+        // X(c =>
+        // {
+        // #if DEBUG
+        //      Y();
+        // #else
+        //      Z();
+        // #endif
+        // });
+        //
+        // Converting this to an expression body is a little too complex for us to support currently. We'd have to grab
+        // out the parts of the #else/#elif blocks, grab out their expressions, and rewrite into a form like so:
+        //
+        // X(c =>
+        // #if DEBUG
+        //      Y()
+        // #else
+        //      Z()
+        // #endif
+        // );
+        if (semicolonToken.TrailingTrivia.Any(t => t.IsDirective))
+            return false;
+
+        return true;
     }
 }
diff --git a/src/Features/CSharp/Portable/UseExpressionBody/UseExpressionBodyCodeRefactoringProvider.cs b/src/Features/CSharp/Portable/UseExpressionBody/UseExpressionBodyCodeRefactoringProvider.cs
index 70ab88f8b6b8c..56b6366f8a0c5 100644
--- a/src/Features/CSharp/Portable/UseExpressionBody/UseExpressionBodyCodeRefactoringProvider.cs
+++ b/src/Features/CSharp/Portable/UseExpressionBody/UseExpressionBodyCodeRefactoringProvider.cs
@@ -28,19 +28,15 @@ namespace Microsoft.CodeAnalysis.CSharp.UseExpressionBody;
 
 [ExportCodeRefactoringProvider(LanguageNames.CSharp, Name = PredefinedCodeRefactoringProviderNames.UseExpressionBody), Shared]
 [ExtensionOrder(Before = PredefinedCodeRefactoringProviderNames.ExtractClass)]
-internal class UseExpressionBodyCodeRefactoringProvider : SyntaxEditorBasedCodeRefactoringProvider
+[method: ImportingConstructor]
+[method: SuppressMessage("RoslynDiagnosticsReliability", "RS0033:Importing constructor should be [Obsolete]", Justification = "Used in test code: https://github.com/dotnet/roslyn/issues/42814")]
+internal sealed class UseExpressionBodyCodeRefactoringProvider() : SyntaxEditorBasedCodeRefactoringProvider
 {
     private static readonly ImmutableArray<UseExpressionBodyHelper> _helpers = UseExpressionBodyHelper.Helpers;
 
     private static readonly BidirectionalMap<(UseExpressionBodyHelper helper, bool useExpressionBody), string> s_equivalenceKeyMap
         = CreateEquivalanceKeyMap(UseExpressionBodyHelper.Helpers);
 
-    [ImportingConstructor]
-    [SuppressMessage("RoslynDiagnosticsReliability", "RS0033:Importing constructor should be [Obsolete]", Justification = "Used in test code: https://github.com/dotnet/roslyn/issues/42814")]
-    public UseExpressionBodyCodeRefactoringProvider()
-    {
-    }
-
     private static BidirectionalMap<(UseExpressionBodyHelper helper, bool useExpressionBody), string> CreateEquivalanceKeyMap(
         ImmutableArray<UseExpressionBodyHelper> helpers)
     {
@@ -127,9 +123,9 @@ private static bool TryComputeRefactoring(
             context.RegisterRefactoring(
                 CodeAction.Create(
                     helper.UseExpressionBodyTitle.ToString(),
-                    c => UpdateDocumentAsync(
+                    cancellationToken => UpdateDocumentAsync(
                         document, root, declaration, helper,
-                        useExpressionBody: true, cancellationToken: c),
+                        useExpressionBody: true, cancellationToken),
                     s_equivalenceKeyMap[(helper, useExpressionBody: true)]),
                 declaration.Span);
             succeeded = true;
@@ -140,9 +136,9 @@ private static bool TryComputeRefactoring(
             context.RegisterRefactoring(
                 CodeAction.Create(
                     helper.UseBlockBodyTitle.ToString(),
-                    c => UpdateDocumentAsync(
+                    cancellationToken => UpdateDocumentAsync(
                         document, root, declaration, helper,
-                        useExpressionBody: false, cancellationToken: c),
+                        useExpressionBody: false, cancellationToken),
                     s_equivalenceKeyMap[(helper, useExpressionBody: false)]),
                 declaration.Span);
             succeeded = true;
diff --git a/src/Features/CSharp/Portable/UseExpressionBodyForLambda/UseExpressionBodyForLambdaCodeRefactoringProvider.cs b/src/Features/CSharp/Portable/UseExpressionBodyForLambda/UseExpressionBodyForLambdaCodeRefactoringProvider.cs
index 124e0daf8ad2e..4b4f7d5970f22 100644
--- a/src/Features/CSharp/Portable/UseExpressionBodyForLambda/UseExpressionBodyForLambdaCodeRefactoringProvider.cs
+++ b/src/Features/CSharp/Portable/UseExpressionBodyForLambda/UseExpressionBodyForLambdaCodeRefactoringProvider.cs
@@ -22,14 +22,10 @@
 namespace Microsoft.CodeAnalysis.CSharp.UseExpressionBodyForLambda;
 
 [ExportCodeRefactoringProvider(LanguageNames.CSharp, Name = PredefinedCodeRefactoringProviderNames.UseExpressionBodyForLambda), Shared]
-internal sealed class UseExpressionBodyForLambdaCodeRefactoringProvider : CodeRefactoringProvider
+[method: ImportingConstructor]
+[method: SuppressMessage("RoslynDiagnosticsReliability", "RS0033:Importing constructor should be [Obsolete]", Justification = "Used in test code: https://github.com/dotnet/roslyn/issues/42814")]
+internal sealed class UseExpressionBodyForLambdaCodeRefactoringProvider() : CodeRefactoringProvider
 {
-    [ImportingConstructor]
-    [SuppressMessage("RoslynDiagnosticsReliability", "RS0033:Importing constructor should be [Obsolete]", Justification = "Used in test code: https://github.com/dotnet/roslyn/issues/42814")]
-    public UseExpressionBodyForLambdaCodeRefactoringProvider()
-    {
-    }
-
     public override async Task ComputeRefactoringsAsync(CodeRefactoringContext context)
     {
         var document = context.Document;
diff --git a/src/Features/CSharpTest/UseExpressionBodyForLambda/UseExpressionBodyForLambdasRefactoringTests.cs b/src/Features/CSharpTest/UseExpressionBodyForLambda/UseExpressionBodyForLambdasRefactoringTests.cs
index ebe2273829beb..fed4ea0b006aa 100644
--- a/src/Features/CSharpTest/UseExpressionBodyForLambda/UseExpressionBodyForLambdasRefactoringTests.cs
+++ b/src/Features/CSharpTest/UseExpressionBodyForLambda/UseExpressionBodyForLambdasRefactoringTests.cs
@@ -11,12 +11,13 @@
 using Microsoft.CodeAnalysis.Editor.CSharp.UnitTests.CodeRefactorings;
 using Microsoft.CodeAnalysis.Editor.UnitTests.CodeActions;
 using Microsoft.CodeAnalysis.Test.Utilities;
+using Roslyn.Test.Utilities;
 using Xunit;
 
 namespace Microsoft.CodeAnalysis.Editor.CSharp.UnitTests.UseExpressionBody;
 
 [Trait(Traits.Feature, Traits.Features.CodeActionsUseExpressionBody)]
-public class UseExpressionBodyForLambdasRefactoringTests : AbstractCSharpCodeActionTest_NoEditor
+public sealed class UseExpressionBodyForLambdasRefactoringTests : AbstractCSharpCodeActionTest_NoEditor
 {
     protected override CodeRefactoringProvider CreateCodeRefactoringProvider(TestWorkspace workspace, TestParameters parameters)
         => new UseExpressionBodyForLambdaCodeRefactoringProvider();
@@ -208,4 +209,20 @@ void Goo()
             }
             """, parameters: new TestParameters(options: UseExpressionBody));
     }
+
+    [Fact, WorkItem("https://github.com/dotnet/roslyn/issues/74137")]
+    public async Task TestNotWithPreprocessorDirectives()
+    {
+        await TestMissingAsync(
+            """
+            app.UseSwaggerUI(c [||]=>
+            {
+            #if DEBUG
+                c.SwaggerEndpoint("/swagger/v1/swagger.json", "API V1");
+            #else
+                c.SwaggerEndpoint("/api/swagger/v1/swagger.json", "API V1");
+            #endif
+            });
+            """, parameters: new TestParameters(options: UseExpressionBodyDisabledDiagnostic));
+    }
 }