diff --git a/pkgs/by-name/on/onnxruntime/musl-cstdint.patch b/pkgs/by-name/on/onnxruntime/musl-cstdint.patch
new file mode 100644
index 000000000000..cf98d69fd88f
--- /dev/null
+++ b/pkgs/by-name/on/onnxruntime/musl-cstdint.patch
@@ -0,0 +1,24 @@
+diff --git a/include/onnxruntime/core/framework/tensor_shape.h b/include/onnxruntime/core/framework/tensor_shape.h
+index d4ee4a0e5e..c33bea9cf7 100644
+--- a/include/onnxruntime/core/framework/tensor_shape.h
++++ b/include/onnxruntime/core/framework/tensor_shape.h
+@@ -8,6 +8,7 @@
+ #include <iosfwd>
+ #include <string>
+ #include <vector>
++#include <cstdint>
+ 
+ #include <gsl/gsl>
+ #include "core/common/inlined_containers_fwd.h"
+diff --git a/onnxruntime/test/perftest/strings_helper.h b/onnxruntime/test/perftest/strings_helper.h
+index d6c6f6112a..8580c86db6 100644
+--- a/onnxruntime/test/perftest/strings_helper.h
++++ b/onnxruntime/test/perftest/strings_helper.h
+@@ -7,6 +7,7 @@
+ #include <unordered_map>
+ #include <unordered_set>
+ #include <vector>
++#include <cstdint>
+ 
+ namespace onnxruntime {
+ namespace perftest {
diff --git a/pkgs/by-name/on/onnxruntime/musl-execinfo.patch b/pkgs/by-name/on/onnxruntime/musl-execinfo.patch
new file mode 100644
index 000000000000..3d6b4c014e4d
--- /dev/null
+++ b/pkgs/by-name/on/onnxruntime/musl-execinfo.patch
@@ -0,0 +1,33 @@
+From 7bc56c886c8b9fa27842a14bbb964ffe8e576a9e Mon Sep 17 00:00:00 2001
+From: Jaeyoon Jung <jaeyoon.jung@lge.com>
+Date: Tue, 12 Aug 2025 10:55:52 +0900
+Subject: [PATCH] Fix build with musl
+
+Added __GLIBC__ macro for 'execinfo.h' and related functions as they are
+GLIBC specific and not available in other libc implementation like musl.
+---
+ onnxruntime/core/platform/posix/stacktrace.cc | 4 ++--
+ 1 file changed, 2 insertions(+), 2 deletions(-)
+
+diff --git a/onnxruntime/core/platform/posix/stacktrace.cc b/onnxruntime/core/platform/posix/stacktrace.cc
+index a34f6fd82ddd1..ab00f5fbb233e 100644
+--- a/onnxruntime/core/platform/posix/stacktrace.cc
++++ b/onnxruntime/core/platform/posix/stacktrace.cc
+@@ -3,7 +3,7 @@
+ 
+ #include "core/common/common.h"
+ 
+-#if !defined(__ANDROID__) && !defined(__wasm__) && !defined(_OPSCHEMA_LIB_) && !defined(_AIX)
++#if !defined(__ANDROID__) && !defined(__wasm__) && !defined(_OPSCHEMA_LIB_) && !defined(_AIX) && defined(__GLIBC__)
+ #include <execinfo.h>
+ #endif
+ #include <vector>
+@@ -13,7 +13,7 @@ namespace onnxruntime {
+ std::vector<std::string> GetStackTrace() {
+   std::vector<std::string> stack;
+ 
+-#if !defined(NDEBUG) && !defined(__ANDROID__) && !defined(__wasm__) && !defined(_OPSCHEMA_LIB_)
++#if !defined(NDEBUG) && !defined(__ANDROID__) && !defined(__wasm__) && !defined(_OPSCHEMA_LIB_) && defined(__GLIBC__)
+   constexpr int kCallstackLimit = 64;  // Maximum depth of callstack
+ 
+   void* array[kCallstackLimit];
diff --git a/pkgs/by-name/on/onnxruntime/package.nix b/pkgs/by-name/on/onnxruntime/package.nix
index 0f4de22c3222..4b932dc5996b 100644
--- a/pkgs/by-name/on/onnxruntime/package.nix
+++ b/pkgs/by-name/on/onnxruntime/package.nix
@@ -5,6 +5,7 @@
   fetchFromGitHub,
   applyPatches,
   fetchpatch,
+  fetchurl,
   abseil-cpp_202407,
   cmake,
   cpuinfo,
@@ -151,6 +152,20 @@ effectiveStdenv.mkDerivation (finalAttrs: {
       url = "https://github.com/microsoft/onnxruntime/commit/8ebd0bf1cf02414584d15d7244b07fa97d65ba02.patch";
       hash = "sha256-vX+kaFiNdmqWI91JELcLpoaVIHBb5EPbI7rCAMYAx04=";
     })
+
+    # Skip execinfo include on musl
+    # https://github.com/microsoft/onnxruntime/pull/25726
+    ./musl-execinfo.patch
+    # Add missing include which is only needed on musl (is implied in other includes on glibc)
+    # https://github.com/microsoft/onnxruntime/pull/26969
+    ./musl-cstdint.patch
+
+    # Fix build of unit tests with musl libc
+    # https://github.com/microsoft/onnxruntime/issues/9155
+    (fetchurl {
+      url = "https://gitlab.alpinelinux.org/alpine/aports/-/raw/462dfe0eb4b66948fe48de44545cc22bb64fdf9f/community/onnxruntime/0001-Remove-MATH_NO_EXCEPT-macro.patch";
+      hash = "sha256-BdeGYevZExWWCuJ1lSw0Roy3h+9EbJgFF8qMwVxSn1A=";
+    })
   ];
 
   nativeBuildInputs = [
@@ -302,21 +317,26 @@ effectiveStdenv.mkDerivation (finalAttrs: {
     (lib.cmakeBool "onnxruntime_USE_COMPOSABLE_KERNEL_CK_TILE" false)
   ];
 
-  env = lib.optionalAttrs rocmSupport {
-    MIOPEN_PATH = rocmPackages.miopen;
-    # HIP steps fail to find ROCm libs when not in HIPFLAGS, causing
-    # fatal error: 'rocrand/rocrand.h' file not found
-    HIPFLAGS = lib.concatMapStringsSep " " (pkg: "-I${lib.getInclude pkg}/include") [
-      rocmPackages.hipblas
-      rocmPackages.hipcub
-      rocmPackages.hiprand
-      rocmPackages.hipsparse
-      rocmPackages.rocblas
-      rocmPackages.rocprim
-      rocmPackages.rocrand
-      rocmPackages.rocthrust
-    ];
-  };
+  env =
+    lib.optionalAttrs rocmSupport {
+      MIOPEN_PATH = rocmPackages.miopen;
+      # HIP steps fail to find ROCm libs when not in HIPFLAGS, causing
+      # fatal error: 'rocrand/rocrand.h' file not found
+      HIPFLAGS = lib.concatMapStringsSep " " (pkg: "-I${lib.getInclude pkg}/include") [
+        rocmPackages.hipblas
+        rocmPackages.hipcub
+        rocmPackages.hiprand
+        rocmPackages.hipsparse
+        rocmPackages.rocblas
+        rocmPackages.rocprim
+        rocmPackages.rocrand
+        rocmPackages.rocthrust
+      ];
+    }
+    // lib.optionalAttrs effectiveStdenv.hostPlatform.isMusl {
+      NIX_CFLAGS_COMPILE = "-DFLATBUFFERS_LOCALE_INDEPENDENT=0";
+      GTEST_FILTER = "*:-ContribOpTest.StringNormalizer*";
+    };
 
   doCheck =
     !(
@@ -336,6 +356,7 @@ effectiveStdenv.mkDerivation (finalAttrs: {
   hardeningEnable = lib.optionals (effectiveStdenv.hostPlatform.system == "loongarch64-linux") [
     "nostrictaliasing"
   ];
+  hardeningDisable = lib.optional effectiveStdenv.hostPlatform.isMusl "fortify";
 
   postPatch = ''
     substituteInPlace cmake/libonnxruntime.pc.cmake.in \