diff --git a/sqlx-core/src/sqlite/options/auto_vacuum.rs b/sqlx-core/src/sqlite/options/auto_vacuum.rs
new file mode 100644
index 000000000..677059b08
--- /dev/null
+++ b/sqlx-core/src/sqlite/options/auto_vacuum.rs
@@ -0,0 +1,25 @@
+use crate::error::Error;
+use std::str::FromStr;
+
+#[derive(Debug, Clone)]
+pub enum SqliteAutoVacuum {
+    None,
+    Full,
+    Incremental,
+}
+
+impl SqliteAutoVacuum {
+    pub(crate) fn as_str(&self) -> &'static str {
+        match self {
+            SqliteAutoVacuum::None => "NONE",
+            SqliteAutoVacuum::Full => "FULL",
+            SqliteAutoVacuum::Incremental => "INCREMENTAL",
+        }
+    }
+}
+
+impl Default for SqliteAutoVacuum {
+    fn default() -> Self {
+        SqliteAutoVacuum::None
+    }
+}
diff --git a/sqlx-core/src/sqlite/options/connect.rs b/sqlx-core/src/sqlite/options/connect.rs
index 26df1592c..ad8b708b4 100644
--- a/sqlx-core/src/sqlite/options/connect.rs
+++ b/sqlx-core/src/sqlite/options/connect.rs
@@ -22,11 +22,12 @@ impl ConnectOptions for SqliteConnectOptions {
             // Note that locking_mode should be set before journal_mode; see
             // https://www.sqlite.org/wal.html#use_of_wal_without_shared_memory .
             let init = format!(
-                "PRAGMA locking_mode = {}; PRAGMA journal_mode = {}; PRAGMA foreign_keys = {}; PRAGMA synchronous = {}",
+                "PRAGMA locking_mode = {}; PRAGMA journal_mode = {}; PRAGMA foreign_keys = {}; PRAGMA synchronous = {}; PRAGMA auto_vacuum = {}",
                 self.locking_mode.as_str(),
                 self.journal_mode.as_str(),
                 if self.foreign_keys { "ON" } else { "OFF" },
                 self.synchronous.as_str(),
+                self.auto_vacuum.as_str(),
             );
 
             conn.execute(&*init).await?;
diff --git a/sqlx-core/src/sqlite/options/mod.rs b/sqlx-core/src/sqlite/options/mod.rs
index 0d2a38735..4175498ca 100644
--- a/sqlx-core/src/sqlite/options/mod.rs
+++ b/sqlx-core/src/sqlite/options/mod.rs
@@ -1,5 +1,6 @@
 use std::path::Path;
 
+mod auto_vacuum;
 mod connect;
 mod journal_mode;
 mod locking_mode;
@@ -7,6 +8,7 @@ mod parse;
 mod synchronous;
 
 use crate::connection::LogSettings;
+pub use auto_vacuum::SqliteAutoVacuum;
 pub use journal_mode::SqliteJournalMode;
 pub use locking_mode::SqliteLockingMode;
 use std::{borrow::Cow, time::Duration};
@@ -59,6 +61,7 @@ pub struct SqliteConnectOptions {
     pub(crate) busy_timeout: Duration,
     pub(crate) log_settings: LogSettings,
     pub(crate) synchronous: SqliteSynchronous,
+    pub(crate) auto_vacuum: SqliteAutoVacuum,
 }
 
 impl Default for SqliteConnectOptions {
@@ -82,6 +85,7 @@ impl SqliteConnectOptions {
             busy_timeout: Duration::from_secs(5),
             log_settings: Default::default(),
             synchronous: SqliteSynchronous::Full,
+            auto_vacuum: Default::default(),
         }
     }
 
@@ -160,4 +164,12 @@ impl SqliteConnectOptions {
         self.synchronous = synchronous;
         self
     }
+
+    /// Sets the [auto_vacuum](https://www.sqlite.org/pragma.html#pragma_auto_vacuum) setting for the database connection.
+    ///
+    /// The default auto_vacuum setting is NONE.
+    pub fn auto_vacuum(mut self, auto_vacuum: SqliteAutoVacuum) -> Self {
+        self.auto_vacuum = auto_vacuum;
+        self
+    }
 }