diff --git a/Sources/SwiftLanguageService/CodeActions/RemoveUnusedImports.swift b/Sources/SwiftLanguageService/CodeActions/RemoveUnusedImports.swift
index b375b755c..da4a81ad9 100644
--- a/Sources/SwiftLanguageService/CodeActions/RemoveUnusedImports.swift
+++ b/Sources/SwiftLanguageService/CodeActions/RemoveUnusedImports.swift
@@ -2,7 +2,7 @@
 //
 // This source file is part of the Swift.org open source project
 //
-// Copyright (c) 2014 - 2025 Apple Inc. and the Swift project authors
+// Copyright (c) 2014 - 2026 Apple Inc. and the Swift project authors
 // Licensed under Apache License v2.0 with Runtime Library Exception
 //
 // See https://swift.org/LICENSE.txt for license information
@@ -197,9 +197,14 @@ extension SwiftLanguageService {
         throw ResponseError.unknown("Failed to remove unused imports because the document currently contains errors")
       }
 
-      // Only consider import declarations at the top level and ignore ones eg. inside `#if` clauses since those might
-      // be inactive in the current build configuration and thus we can't reliably check if they are needed.
-      let importDecls = syntaxTree.statements.compactMap { $0.item.as(ImportDeclSyntax.self) }
+      // Fetch active regions from sourcekitd before collecting imports
+      let activeRegions = try await fetchActiveRegions(snapshot: snapshot, compileCommand: compileCommand)
+
+      let importDecls = try await collectImportDecls(
+        from: syntaxTree,
+        snapshot: snapshot,
+        activeRegions: activeRegions ?? []
+      )
 
       var declsToRemove: [ImportDeclSyntax] = []
 
@@ -301,4 +306,115 @@ extension SwiftLanguageService {
       }
     }
   }
+
+  /// Fetches active regions from sourcekitd for the given file and constructs byte ranges
+  /// for active code within conditional compilation blocks. The activeRegions request
+  /// returns a list of entries in `results` containing `offset` and an optional
+  /// `is_active` flag. Each entry marks the start of a region; the next entry’s offset
+  /// is the end boundary.
+  ///
+  /// - Parameters:
+  ///   - snapshot: The document snapshot.
+  ///   - compileCommand: The compile command for the file.
+  /// - Returns: An array of source ranges representing active regions, or nil if the API doesn't return usable data.
+  private func fetchActiveRegions(
+    snapshot: DocumentSnapshot,
+    compileCommand: SwiftCompileCommand
+  ) async throws -> [SourceRange]? {
+    let skreq = sourcekitd.dictionary([
+      keys.sourceFile: snapshot.uri.sourcekitdSourceFile,
+      keys.primaryFile: snapshot.uri.primaryFile?.pseudoPath,
+      keys.compilerArgs: compileCommand.compilerArgs as [any SKDRequestValue],
+    ])
+
+    let dict = try await send(sourcekitdRequest: \.activeRegions, skreq, snapshot: snapshot)
+
+    // Build ranges by pairing each entry with the next entry's offset; include only active ones.
+    guard let results = dict[keys.results] as SKDResponseArray? else {
+      return nil
+    }
+
+    let entries: [(offset: Int, isActive: Bool?)] = results.compactMap { entry in
+      guard let off = entry[keys.offset] as Int? else {
+        return nil
+      }
+      let activeBool = entry[keys.isActive] as Bool?
+      let activeInt = entry[keys.isActive] as Int?
+      return (offset: off, isActive: activeBool ?? activeInt.map { $0 != 0 })
+    }
+    guard !entries.isEmpty else { return [] }
+    let sortedEntries = entries.sorted { $0.offset < $1.offset }
+
+    var ranges: [SourceRange] = []
+    let fileEnd = snapshot.text.utf8.count
+    for (current, next) in zip(sortedEntries, sortedEntries.dropFirst()) {
+      let start = current.offset
+      let end = next.offset
+      let isActive = current.isActive ?? false
+      if isActive, start < end {
+        ranges.append(AbsolutePosition(utf8Offset: start)..<AbsolutePosition(utf8Offset: end))
+      }
+    }
+    if let last = sortedEntries.last {
+      let start = last.offset
+      let end = fileEnd
+      let isActive = last.isActive ?? false
+      if isActive, start < end {
+        ranges.append(AbsolutePosition(utf8Offset: start)..<AbsolutePosition(utf8Offset: end))
+      }
+    }
+    return ranges
+  }
+
+  /// Collects all import declarations that are active.
+  /// This includes top-level imports and imports from #if clauses.
+  ///
+  /// - Parameters:
+  ///   - syntaxTree: The root syntax tree to traverse.
+  ///   - snapshot: The document snapshot.
+  ///   - activeRegions: Array of source ranges representing active #if regions.
+  /// - Returns: An array of import declarations.
+  private func collectImportDecls(
+    from syntaxTree: SourceFileSyntax,
+    snapshot: DocumentSnapshot,
+    activeRegions: [SourceRange]
+  ) async throws -> [ImportDeclSyntax] {
+    let visitor = ImportCollectorVisitor(activeRegions: activeRegions, snapshot: snapshot)
+    visitor.walk(syntaxTree)
+    return visitor.collectedImports
+  }
 }
+
+/// A syntax visitor that collects import declarations from both top-level and #if clauses.
+/// Uses activeRegions from sourcekitd to determine which #if clauses are active.
+private class ImportCollectorVisitor: SyntaxVisitor {
+  private(set) var collectedImports: [ImportDeclSyntax] = []
+  private let activeRegions: [SourceRange]
+  private let snapshot: DocumentSnapshot
+
+  init(activeRegions: [SourceRange], snapshot: DocumentSnapshot, viewMode: SyntaxTreeViewMode = .sourceAccurate) {
+    self.activeRegions = activeRegions
+    self.snapshot = snapshot
+    super.init(viewMode: viewMode)
+  }
+
+  override func visit(_ node: ImportDeclSyntax) -> SyntaxVisitorContinueKind {
+    let startOffset = snapshot.utf8Offset(of: snapshot.position(of: node.positionAfterSkippingLeadingTrivia))
+    let isInIfConfig =
+      node.findParentOfSelf(ofType: IfConfigDeclSyntax.self, stoppingIf: { _ in false }) != nil
+    if !isInIfConfig || isOffsetInActiveRegion(startOffset) {
+      collectedImports.append(node)
+    }
+    return .skipChildren
+  }
+
+  private func isOffsetInActiveRegion(_ offset: Int) -> Bool {
+    guard !activeRegions.isEmpty else {
+      return true
+    }
+    let position = AbsolutePosition(utf8Offset: offset)
+    return activeRegions.contains { $0.contains(position) }
+  }
+}
+
+private typealias SourceRange = Range<AbsolutePosition>
diff --git a/Tests/SourceKitLSPTests/CodeActionTests.swift b/Tests/SourceKitLSPTests/CodeActionTests.swift
index d36dde054..d66a053a3 100644
--- a/Tests/SourceKitLSPTests/CodeActionTests.swift
+++ b/Tests/SourceKitLSPTests/CodeActionTests.swift
@@ -1521,7 +1521,7 @@ final class CodeActionTests: SourceKitLSPTestCase {
         let package = Package(
           name: "MyLibrary",
           targets: [
-            .target(name: "Test", swiftSettings: [.enableUpcomingFeature("MemberImportVisibility")]c)
+            .target(name: "Test", swiftSettings: [.enableUpcomingFeature("MemberImportVisibility")])
           ]
         )
         """,
@@ -1545,6 +1545,101 @@ final class CodeActionTests: SourceKitLSPTestCase {
     )
   }
 
+  func testRemoveUnusedImportsHandlesActiveIfClauses() async throws {
+    let project = try await SwiftPMTestProject(
+      files: [
+        "LibA/LibA.swift": "",
+        "LibB/LibB.swift": "",
+        "Test/Test.swift": """
+        #if canImport(Darwin)
+        1️⃣import Darwin // Unused, should be removed on macOS
+        #elseif canImport(Glibc)
+        2️⃣import Glibc3️⃣  // Inactive on macOS, must NOT be removed
+        #endif
+
+        4️⃣import LibA
+        5️⃣import LibB6️⃣
+
+        func test() {
+          print("Hello")
+        }
+        """,
+      ],
+      manifest: """
+        let package = Package(
+          name: "MyLibrary",
+          targets: [
+            .target(name: "LibA"),
+            .target(name: "LibB"),
+            .target(
+              name: "Test",
+              dependencies: ["LibA", "LibB"],
+              swiftSettings: [.enableUpcomingFeature("MemberImportVisibility")]
+            )
+          ]
+        )
+        """,
+      capabilities: clientCapabilitiesWithCodeActionSupport,
+      enableBackgroundIndexing: true
+    )
+
+    let (uri, positions) = try project.openDocument("Test.swift")
+
+    let importResult = try await project.testClient.send(
+      CodeActionRequest(
+        range: Range(positions["1️⃣"]),
+        context: CodeActionContext(),
+        textDocument: TextDocumentIdentifier(uri)
+      )
+    )
+    let removeUnusedImportsCommand = try XCTUnwrap(
+      importResult?.codeActions?.first(where: {
+        $0.command?.command == "remove.unused.imports.command"
+      })?.command
+    )
+
+    project.testClient.handleSingleRequest { (request: ApplyEditRequest) -> ApplyEditResponse in
+      // Should remove Darwin and LibA/LibB imports, but NOT the Glibc import (which is in an inactive #if clause)
+      guard let changesDict = request.edit.changes,
+        let changes = changesDict[uri]
+      else {
+        XCTFail("Expected edits for the test file")
+        return ApplyEditResponse(applied: false, failureReason: "No edits")
+      }
+
+      // Verify we have 3 edits (Darwin, LibA, LibB)
+      XCTAssertEqual(changes.count, 3, "Expected 3 import removals")
+
+      let expectedPositions = [
+        positions["1️⃣"],
+        positions["4️⃣"],
+        positions["5️⃣"],
+      ]
+
+      for expected in expectedPositions {
+        XCTAssertTrue(
+          changes.contains(where: { $0.range.contains(expected) }),
+          "Expected an edit containing \(expected)"
+        )
+      }
+
+      // Verify Glibc import range is NOT in the edits
+      XCTAssertFalse(
+        changes.contains(where: { $0.range.contains(positions["2️⃣"]) }),
+        "Glibc import should not be removed (it's in an inactive clause)"
+      )
+
+      return ApplyEditResponse(applied: true, failureReason: nil)
+    }
+
+    _ = try await project.testClient.send(
+      ExecuteCommandRequest(
+        command: removeUnusedImportsCommand.command,
+        arguments: removeUnusedImportsCommand.arguments
+      )
+    )
+  }
+
   func testConvertFunctionZeroParameterToComputedProperty() async throws {
     let testClient = try await TestSourceKitLSPClient(capabilities: clientCapabilitiesWithCodeActionSupport)
     let uri = DocumentURI(for: .swift)