diff --git a/src/lib/libatomic.js b/src/lib/libatomic.js
index 1ea3625244eb1..d636c8ddff782 100644
--- a/src/lib/libatomic.js
+++ b/src/lib/libatomic.js
@@ -75,17 +75,22 @@ addToLibrary({
   },
 
 #if ASYNCIFY
-  _emscripten_atomic_wait_promise__deps: ['$polyfillWaitAsync', '$atomicWaitStates', '$addPromise'],
+  _emscripten_atomic_wait_promise__deps: ['$polyfillWaitAsync', '$atomicWaitStates'],
   _emscripten_atomic_wait_promise: (addr, val, maxWaitMilliseconds) => {
     var wait = Atomics.waitAsync(HEAP32, {{{ getHeapOffset('addr', 'i32') }}}, val, maxWaitMilliseconds);
     if (wait.async) {
       // In the async case return the promise ID.
       var chainedPromise = wait.value.then((value) => atomicWaitStates.indexOf(value));
-      var id = addPromise(chainedPromise);
-      return id;
+#if RUNTIME_DEBUG
+      dbg("returning promise, -1 pair")
+#endif
+      return [chainedPromise, -1];
     }
+#if RUNTIME_DEBUG
+    dbg("_emscripten_atomic_wait_promise returning sync result: " + wait.value)
+#endif
     // In the synchronous case return the negative result code
-    return -atomicWaitStates.indexOf(wait.value);
+    return [undefined, atomicWaitStates.indexOf(wait.value)]
   },
 #else
   _emscripten_atomic_wait_promise: (addr, val, maxWaitMilliseconds) => {
diff --git a/src/lib/libpromise.js b/src/lib/libpromise.js
index 35a5700c2925c..c1fc31f186d3d 100644
--- a/src/lib/libpromise.js
+++ b/src/lib/libpromise.js
@@ -268,6 +268,17 @@ addToLibrary({
 #endif
     return getPromise(id);
   },
+
+  // Just like emscripten_promise_await_unchecked above except the argument
+  // is an actual JS promise.  We call this from Wasm when we have an `externref`
+  // that refers to a JS promise object.
+  emscripten_promise_ref_await_unchecked__async: 'auto',
+  emscripten_promise_ref_await_unchecked: (promise) => {
+#if RUNTIME_DEBUG
+    dbg(`emscripten_promise_ref_await_unchecked: ${promise}`);
+#endif
+    return promise;
+  },
 #else
   emscripten_promise_await: (returnValuePtr, id) => {
     abort('emscripten_promise_await is only available with ASYNCIFY');
@@ -276,5 +287,8 @@ addToLibrary({
     abort('emscripten_promise_await_unchecked is only available with ASYNCIFY');
     return 0;
   },
+  emscripten_promise_ref_await_unchecked: (id) => {
+    abort('emscripten_promise_await_unchecked is only available with ASYNCIFY');
+  },
 #endif
 });
diff --git a/src/lib/libsigs.js b/src/lib/libsigs.js
index b26e411a62364..4438d8bcb48a4 100644
--- a/src/lib/libsigs.js
+++ b/src/lib/libsigs.js
@@ -314,7 +314,6 @@ sigs = {
   _embind_register_value_object__sig: 'vpppppp',
   _embind_register_value_object_field__sig: 'vpppppppppp',
   _embind_register_void__sig: 'vpp',
-  _emscripten_atomic_wait_promise__sig: 'ppid',
   _emscripten_create_audio_worklet__sig: 'viipippp',
   _emscripten_create_wasm_worker__sig: 'iipip',
   _emscripten_dlopen_js__sig: 'vpppp',
@@ -728,6 +727,7 @@ sigs = {
   emscripten_promise_create__sig: 'p',
   emscripten_promise_destroy__sig: 'vp',
   emscripten_promise_race__sig: 'ppp',
+  emscripten_promise_ref_await_unchecked__sig: 'pr',
   emscripten_promise_resolve__sig: 'vpip',
   emscripten_promise_then__sig: 'ppppp',
   emscripten_random__sig: 'f',
diff --git a/system/include/emscripten/promise.h b/system/include/emscripten/promise.h
index a805b364ecbb3..1efd4cf593ac8 100644
--- a/system/include/emscripten/promise.h
+++ b/system/include/emscripten/promise.h
@@ -153,6 +153,8 @@ emscripten_promise_await(em_promise_t promise);
 // chain, or result in a top level unhandled rejection.
 [[nodiscard]] void* emscripten_promise_await_unchecked(em_promise_t promise);
 
+[[nodiscard]] void* emscripten_promise_ref_await_unchecked(__externref_t promise);
+
 #ifdef __cplusplus
 }
 #endif
diff --git a/system/lib/pthread/emscripten_atomic_wait_promise_asm.S b/system/lib/pthread/emscripten_atomic_wait_promise_asm.S
new file mode 100644
index 0000000000000..f068772118736
--- /dev/null
+++ b/system/lib/pthread/emscripten_atomic_wait_promise_asm.S
@@ -0,0 +1,35 @@
+/*
+ * Copyright 2026 The Emscripten Authors.  All rights reserved.
+ * Emscripten is available under two separate licenses, the MIT license and the
+ * University of Illinois/NCSA Open Source License.  Both these licenses can be
+ * found in the LICENSE file.
+ *
+ * Helper function for emscripten_atomic_wait_suspending.
+ *
+ * This function uses multi-value so it cannot be expressed in C code.  W
+ * call out to the `_emscripten_atomic_wait_promise` JS library function which
+ * returns a pair of [ Promise|undefined, result code ].   We then write the
+ * result code to an out parameter and return the Promise as an externref
+ */
+
+#ifdef __wasm64__
+#define PTR i64
+#else
+#define PTR i32
+#endif
+
+.functype _emscripten_atomic_wait_promise (PTR, i32, f64) -> (externref, i32)
+
+.globl _emscripten_atomic_wait_promise_asm
+_emscripten_atomic_wait_promise_asm:
+  .functype _emscripten_atomic_wait_promise_asm (PTR, i32, f64, PTR) -> (externref)
+  .local i32
+  local.get 0
+  local.get 1
+  local.get 2
+  call _emscripten_atomic_wait_promise
+  local.set 4
+  local.get 3
+  local.get 4
+  i32.store 0
+  end_function
diff --git a/system/lib/pthread/emscripten_atomic_wait_suspending.c b/system/lib/pthread/emscripten_atomic_wait_suspending.c
index 32e09ddd25ed5..6006b629cc770 100644
--- a/system/lib/pthread/emscripten_atomic_wait_suspending.c
+++ b/system/lib/pthread/emscripten_atomic_wait_suspending.c
@@ -5,21 +5,29 @@
  * found in the LICENSE file.
  */
 
-#include <emscripten/promise.h>
 #include <emscripten/atomic.h>
+#include <emscripten/console.h>
+#include <emscripten/promise.h>
 #include "threading_internal.h"
 
+// Internal promise-returning API used to implement
+// emscripten_atomic_wait_syspending.
+__externref_t _emscripten_atomic_wait_promise_asm(volatile void *addr,
+                                                  uint32_t value,
+                                                  double maxWaitMilliseconds,
+                                                  int32_t* result);
+
 ATOMICS_WAIT_TOKEN_T emscripten_atomic_wait_suspending(volatile void * _Nonnull addr,
                                                        uint32_t value,
                                                        double maxWaitMilliseconds) {
-  intptr_t res = _emscripten_atomic_wait_promise(addr, value, maxWaitMilliseconds);
+  int32_t result = 42;
+  __externref_t promise = _emscripten_atomic_wait_promise_asm(addr, value, maxWaitMilliseconds, &result);
   // A negative value is a synchronous result code.
-  if (res < 0) {
-     return (ATOMICS_WAIT_TOKEN_T)-res;
+  if (result != -1) {
+    return (ATOMICS_WAIT_TOKEN_T)result;
   }
   // Otherwise a positive value is a promise ID, and we can then `await` using
   // ASYNCIFY/JSPI.
-  em_promise_t promise = (em_promise_t)res;
-  void* await_result = emscripten_promise_await_unchecked(promise);
+  void* await_result = emscripten_promise_ref_await_unchecked(promise);
   return (ATOMICS_WAIT_TOKEN_T)(intptr_t)await_result;
 }
diff --git a/system/lib/pthread/threading_internal.h b/system/lib/pthread/threading_internal.h
index f84a8e5444ab1..2ac7ba2dd4a31 100644
--- a/system/lib/pthread/threading_internal.h
+++ b/system/lib/pthread/threading_internal.h
@@ -132,9 +132,3 @@ void* _emscripten_init_pthread(void *base, size_t* size, pid_t tid);
 // __builtin_wasm_memory_atomic_waitXX then they will not be woken by
 // this method.
 void _emscripten_thread_notify(pthread_t thread);
-
-// Internal, promise-returning API used to implement
-// emscripten_atomic_wait_suspending.
-intptr_t _emscripten_atomic_wait_promise(volatile void *addr,
-                                         uint32_t value,
-                                         double maxWaitMilliseconds);
diff --git a/tools/maint/gen_sig_info.py b/tools/maint/gen_sig_info.py
index 8b04cac54fd5f..1a7a469efdd08 100755
--- a/tools/maint/gen_sig_info.py
+++ b/tools/maint/gen_sig_info.py
@@ -179,6 +179,7 @@ def ignore_symbol(s, cxx):
     return True
   if s in {'__stack_base', '__memory_base', '__table_base', '__global_base', '__heap_base',
            '__stack_pointer', '__stack_high', '__stack_low',
+           '_emscripten_atomic_wait_promise',
            # legacy aliases, not callable from native code.
            'stackSave', 'stackRestore', 'stackAlloc', 'getTempRet0', 'setTempRet0',
            }:
@@ -207,6 +208,7 @@ def valuetype_to_chr(t, t64):
     webassembly.Type.I64: 'j',
     webassembly.Type.F32: 'f',
     webassembly.Type.F64: 'd',
+    webassembly.Type.EXTERNREF: 'r',
   }[t]
 
 
diff --git a/tools/system_libs.py b/tools/system_libs.py
index f95110fc383ff..35150f4cefe21 100644
--- a/tools/system_libs.py
+++ b/tools/system_libs.py
@@ -1284,6 +1284,7 @@ def get_files(self):
           'emscripten_futex_wait.c',
           'emscripten_futex_wake.c',
           'emscripten_atomic_wait_suspending.c',
+          'emscripten_atomic_wait_promise_asm.S',
         ])
 
     # These files are in libc directories, but only built in libc_optz.