diff --git a/.changeset/happy-ears-call.md b/.changeset/happy-ears-call.md
new file mode 100644
index 0000000000000..0287a7f28eb44
--- /dev/null
+++ b/.changeset/happy-ears-call.md
@@ -0,0 +1,5 @@
+---
+'@astrojs/react': minor
+---
+
+Prevent ID collisions in React.useId
diff --git a/packages/integrations/react/client.js b/packages/integrations/react/client.js
index 3807ab41069f4..366d499e3ad75 100644
--- a/packages/integrations/react/client.js
+++ b/packages/integrations/react/client.js
@@ -13,6 +13,9 @@ function isAlreadyHydrated(element) {
 export default (element) =>
 	(Component, props, { default: children, ...slotted }, { client }) => {
 		if (!element.hasAttribute('ssr')) return;
+		const renderOptions = {
+			identifierPrefix: element.getAttribute('prefix')
+		}
 		for (const [key, value] of Object.entries(slotted)) {
 			props[key] = createElement(StaticHtml, { value, name: key });
 		}
@@ -28,10 +31,10 @@ export default (element) =>
 		}
 		if (client === 'only') {
 			return startTransition(() => {
-				createRoot(element).render(componentEl);
+				createRoot(element, renderOptions).render(componentEl);
 			});
 		}
 		return startTransition(() => {
-			hydrateRoot(element, componentEl);
+			hydrateRoot(element, componentEl, renderOptions);
 		});
 	};
diff --git a/packages/integrations/react/context.js b/packages/integrations/react/context.js
new file mode 100644
index 0000000000000..c999c53d3a68f
--- /dev/null
+++ b/packages/integrations/react/context.js
@@ -0,0 +1,21 @@
+const contexts = new WeakMap();
+
+export function getContext(result) {
+	if (contexts.has(result)) {
+		return contexts.get(result);
+	}
+	let ctx = {
+		c: 0,
+		get id() {
+			return 'r' + this.c.toString();
+		},
+	};
+	contexts.set(result, ctx);
+	return ctx;
+}
+
+export function incrementId(ctx) {
+	let id = ctx.id;
+	ctx.c++;
+	return id;
+}
diff --git a/packages/integrations/react/server.js b/packages/integrations/react/server.js
index 01a135a9ba4c0..f9c03e2250831 100644
--- a/packages/integrations/react/server.js
+++ b/packages/integrations/react/server.js
@@ -1,6 +1,7 @@
 import React from 'react';
 import ReactDOM from 'react-dom/server';
 import StaticHtml from './static-html.js';
+import { getContext, incrementId } from './context.js';
 
 const slotName = (str) => str.trim().replace(/[-_]([a-z])/g, (_, w) => w.toUpperCase());
 const reactTypeof = Symbol.for('react.element');
@@ -58,6 +59,12 @@ async function getNodeWritable() {
 }
 
 async function renderToStaticMarkup(Component, props, { default: children, ...slotted }, metadata) {
+	let prefix;
+	if (this && this.result) {
+		prefix = incrementId(getContext(this.result))
+	}
+	const attrs = { prefix };
+
 	delete props['class'];
 	const slots = {};
 	for (const [key, value] of Object.entries(slotted)) {
@@ -74,29 +81,33 @@ async function renderToStaticMarkup(Component, props, { default: children, ...sl
 		newProps.children = React.createElement(StaticHtml, { value: newChildren });
 	}
 	const vnode = React.createElement(Component, newProps);
+	const renderOptions = {
+		identifierPrefix: prefix
+	}
 	let html;
 	if (metadata && metadata.hydrate) {
 		if ('renderToReadableStream' in ReactDOM) {
-			html = await renderToReadableStreamAsync(vnode);
+			html = await renderToReadableStreamAsync(vnode, renderOptions);
 		} else {
-			html = await renderToPipeableStreamAsync(vnode);
+			html = await renderToPipeableStreamAsync(vnode, renderOptions);
 		}
 	} else {
 		if ('renderToReadableStream' in ReactDOM) {
-			html = await renderToReadableStreamAsync(vnode);
+			html = await renderToReadableStreamAsync(vnode, renderOptions);
 		} else {
-			html = await renderToStaticNodeStreamAsync(vnode);
+			html = await renderToStaticNodeStreamAsync(vnode, renderOptions);
 		}
 	}
-	return { html };
+	return { html, attrs };
 }
 
-async function renderToPipeableStreamAsync(vnode) {
+async function renderToPipeableStreamAsync(vnode, options) {
 	const Writable = await getNodeWritable();
 	let html = '';
 	return new Promise((resolve, reject) => {
 		let error = undefined;
 		let stream = ReactDOM.renderToPipeableStream(vnode, {
+			...options,
 			onError(err) {
 				error = err;
 				reject(error);
@@ -118,11 +129,11 @@ async function renderToPipeableStreamAsync(vnode) {
 	});
 }
 
-async function renderToStaticNodeStreamAsync(vnode) {
+async function renderToStaticNodeStreamAsync(vnode, options) {
 	const Writable = await getNodeWritable();
 	let html = '';
 	return new Promise((resolve, reject) => {
-		let stream = ReactDOM.renderToStaticNodeStream(vnode);
+		let stream = ReactDOM.renderToStaticNodeStream(vnode, options);
 		stream.on('error', (err) => {
 			reject(err);
 		});
@@ -164,8 +175,8 @@ async function readResult(stream) {
 	}
 }
 
-async function renderToReadableStreamAsync(vnode) {
-	return await readResult(await ReactDOM.renderToReadableStream(vnode));
+async function renderToReadableStreamAsync(vnode, options) {
+	return await readResult(await ReactDOM.renderToReadableStream(vnode, options));
 }
 
 export default {