diff --git a/sentry-ruby/lib/sentry/rack/capture_exceptions.rb b/sentry-ruby/lib/sentry/rack/capture_exceptions.rb
index a97f93079..78378942e 100644
--- a/sentry-ruby/lib/sentry/rack/capture_exceptions.rb
+++ b/sentry-ruby/lib/sentry/rack/capture_exceptions.rb
@@ -135,6 +135,7 @@ def extract_queue_time(env)
       # Parses X-Request-Start header value to extract a timestamp.
       # Supports multiple formats:
       #   - Nginx: "t=1234567890.123" (seconds with decimal)
+      #   - Render: "t=1234567890123456789" (nanoseconds)
       #   - Heroku, HAProxy 1.9+: "t=1234567890123456" (microseconds)
       #   - HAProxy < 1.9: "t=1234567890" (seconds)
       #   - Generic: "1234567890.123" (raw timestamp)
@@ -158,9 +159,12 @@ def parse_request_start_header(header_value)
           return
         end
 
-        # normalize: timestamps can be in seconds, milliseconds or microseconds
-        # any timestamp > 10 trillion = microseconds
-        if timestamp > 10_000_000_000_000
+        # normalize: timestamps can be in seconds, milliseconds, microseconds or nanoseconds
+        # any timestamp > 10 quadrillion = nanoseconds
+        if timestamp > 10_000_000_000_000_000
+          timestamp / 1_000_000_000.0
+        # timestamp > 10 trillion & < 10 quadrillion = microseconds
+        elsif timestamp > 10_000_000_000_000
           timestamp / 1_000_000.0
         # timestamp > 10 billion & < 10 trillion = milliseconds
         elsif timestamp > 10_000_000_000
diff --git a/sentry-ruby/spec/sentry/rack/capture_exceptions_spec.rb b/sentry-ruby/spec/sentry/rack/capture_exceptions_spec.rb
index 8a037595b..d716ed610 100644
--- a/sentry-ruby/spec/sentry/rack/capture_exceptions_spec.rb
+++ b/sentry-ruby/spec/sentry/rack/capture_exceptions_spec.rb
@@ -738,6 +738,18 @@ def will_be_sampled_by_sdk
           expect(queue_time).to be_within(10).of(30)
         end
       end
+
+      it "handles Render nanosecond timestamp format" do
+        Timecop.freeze do
+          timestamp_ns = ((Time.now.to_f - 0.03) * 1_000_000_000).to_i
+          env["HTTP_X_REQUEST_START"] = "t=#{timestamp_ns}"
+
+          stack.call(env)
+
+          queue_time = transaction.contexts.dig(:trace, :data, 'http.server.request.time_in_queue')
+          expect(queue_time).to be_within(10).of(30)
+        end
+      end
     end
 
     context "without X-Request-Start header" do