diff --git a/pkgs/by-name/on/onnxruntime/package.nix b/pkgs/by-name/on/onnxruntime/package.nix
index 05ecb2453419..bd91c2d2584f 100644
--- a/pkgs/by-name/on/onnxruntime/package.nix
+++ b/pkgs/by-name/on/onnxruntime/package.nix
@@ -14,6 +14,7 @@
   howard-hinnant-date,
   libpng,
   nlohmann_json,
+  perl,
   pkg-config,
   python3Packages,
   re2,
@@ -24,8 +25,10 @@
   pythonSupport ? true,
   cudaSupport ? config.cudaSupport,
   ncclSupport ? cudaSupport && cudaPackages.nccl.meta.available,
+  rocmSupport ? config.rocmSupport,
   withFullProtobuf ? false,
   cudaPackages ? { },
+  rocmPackages,
 }@inputs:
 
 let
@@ -121,6 +124,9 @@ effectiveStdenv.mkDerivation rec {
   ]
   ++ lib.optionals isCudaJetson [
     cudaPackages.autoAddCudaCompatRunpath
+  ]
+  ++ lib.optionals rocmSupport [
+    perl # for tools/ci_build/hipify-perl
   ];
 
   buildInputs = [
@@ -156,6 +162,22 @@ effectiveStdenv.mkDerivation rec {
     ]
     ++ lib.optionals ncclSupport [ nccl ]
   )
+  ++ lib.optionals rocmSupport [
+    rocmPackages.clr
+    rocmPackages.hipblas
+    rocmPackages.hipcub
+    rocmPackages.hipfft
+    rocmPackages.hiprand
+    rocmPackages.hipsparse
+    rocmPackages.rocblas
+    rocmPackages.rocprim
+    rocmPackages.rocrand
+    rocmPackages.rocthrust
+    rocmPackages.miopen
+    rocmPackages.rccl
+    rocmPackages.rocm-smi
+    rocmPackages.roctracer
+  ]
   ++ lib.optionals effectiveStdenv.hostPlatform.isDarwin [
     (darwinMinVersionHook "13.3")
   ];
@@ -203,6 +225,7 @@ effectiveStdenv.mkDerivation rec {
     (lib.cmakeBool "onnxruntime_USE_FULL_PROTOBUF" withFullProtobuf)
     (lib.cmakeBool "onnxruntime_USE_CUDA" cudaSupport)
     (lib.cmakeBool "onnxruntime_USE_NCCL" (cudaSupport && ncclSupport))
+    (lib.cmakeBool "onnxruntime_USE_ROCM" rocmSupport)
     (lib.cmakeBool "onnxruntime_ENABLE_LTO" (!cudaSupport || cudaPackages.cudaOlder "12.8"))
   ]
   ++ lib.optionals pythonSupport [
@@ -213,15 +236,43 @@ effectiveStdenv.mkDerivation rec {
     (lib.cmakeFeature "onnxruntime_CUDNN_HOME" "${cudaPackages.cudnn}")
     (lib.cmakeFeature "CMAKE_CUDA_ARCHITECTURES" cudaArchitecturesString)
     (lib.cmakeFeature "onnxruntime_NVCC_THREADS" "1")
+  ]
+  ++ lib.optionals rocmSupport [
+    # Werror combines with rocprim header issues to cause errors (warp size const deprecation)
+    "--compile-no-warning-as-error"
+    (lib.cmakeFeature "CMAKE_HIP_ARCHITECTURES" (
+      builtins.concatStringsSep ";" rocmPackages.clr.localGpuTargets or rocmPackages.clr.gpuTargets
+    ))
+    (lib.cmakeFeature "onnxruntime_ROCM_HOME" "${rocmPackages.clr}")
+    # Incompatible with packaged version, far too slow to build vendored version
+    (lib.cmakeBool "onnxruntime_USE_COMPOSABLE_KERNEL" false)
+    (lib.cmakeBool "onnxruntime_USE_COMPOSABLE_KERNEL_CK_TILE" false)
   ];
 
-  env = lib.optionalAttrs effectiveStdenv.cc.isClang {
-    NIX_CFLAGS_COMPILE = "-Wno-error";
-  };
+  env =
+    lib.optionalAttrs effectiveStdenv.cc.isClang {
+      NIX_CFLAGS_COMPILE = "-Wno-error";
+    }
+    // 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
+      ];
+    };
 
   doCheck =
     !(
       cudaSupport
+      || rocmSupport
       || builtins.elem effectiveStdenv.buildPlatform.system [
         # aarch64-linux fails cpuinfo test, because /sys/devices/system/cpu/ does not exist in the sandbox
         "aarch64-linux"
@@ -231,7 +282,7 @@ effectiveStdenv.mkDerivation rec {
       ]
     );
 
-  requiredSystemFeatures = lib.optionals cudaSupport [ "big-parallel" ];
+  requiredSystemFeatures = lib.optionals (cudaSupport || rocmSupport) [ "big-parallel" ];
 
   hardeningEnable = lib.optionals (effectiveStdenv.hostPlatform.system == "loongarch64-linux") [
     "nostrictaliasing"
@@ -247,6 +298,9 @@ effectiveStdenv.mkDerivation rec {
       "GetRuntimePath() const { return PathString(); }" \
       "GetRuntimePath() const { return PathString(\"$out/lib/\"); }"
   ''
+  + lib.optionalString rocmSupport ''
+    patchShebangs tools/ci_build/hipify-perl
+  ''
   + lib.optionalString (effectiveStdenv.hostPlatform.system == "aarch64-linux") ''
     # https://github.com/NixOS/nixpkgs/pull/226734#issuecomment-1663028691
     rm -v onnxruntime/test/optimizer/nhwc_transformer_test.cc