diff --git a/dist/core/rules/alt-require.js b/dist/core/rules/alt-require.js
index 5532b39db..24a4d0eb6 100644
--- a/dist/core/rules/alt-require.js
+++ b/dist/core/rules/alt-require.js
@@ -5,11 +5,14 @@ exports.default = {
     description: 'The alt attribute of an <img> element must be present and alt attribute of area[href] and input[type=image] must have a value.',
     init(parser, reporter) {
         parser.addListener('tagstart', (event) => {
+            var _a;
             const tagName = event.tagName.toLowerCase();
             const mapAttrs = parser.getMapAttrs(event.attrs);
             const col = event.col + tagName.length + 1;
             let selector;
-            if (tagName === 'img' && !('alt' in mapAttrs)) {
+            if (tagName === 'img' &&
+                !('alt' in mapAttrs) &&
+                ((_a = mapAttrs['aria-hidden']) === null || _a === void 0 ? void 0 : _a.trim().toLowerCase()) !== 'true') {
                 reporter.warn('An alt attribute must be present on <img> elements.', event.line, col, this, event.raw);
             }
             else if ((tagName === 'area' && 'href' in mapAttrs) ||
@@ -22,4 +25,4 @@ exports.default = {
         });
     },
 };
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\ No newline at end of file
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\ No newline at end of file
diff --git a/src/core/rules/alt-require.ts b/src/core/rules/alt-require.ts
index cc51c4a9a..4f0d69d95 100644
--- a/src/core/rules/alt-require.ts
+++ b/src/core/rules/alt-require.ts
@@ -11,7 +11,11 @@ export default {
       const col = event.col + tagName.length + 1
       let selector
 
-      if (tagName === 'img' && !('alt' in mapAttrs)) {
+      if (
+        tagName === 'img' &&
+        !('alt' in mapAttrs) &&
+        mapAttrs['aria-hidden']?.trim().toLowerCase() !== 'true'
+      ) {
         reporter.warn(
           'An alt attribute must be present on <img> elements.',
           event.line,
diff --git a/test/rules/alt-require.spec.js b/test/rules/alt-require.spec.js
index 31ce8ee2a..d1eccd774 100644
--- a/test/rules/alt-require.spec.js
+++ b/test/rules/alt-require.spec.js
@@ -18,6 +18,34 @@ describe(`Rules: ${ruleId}`, () => {
     expect(messages.length).toBe(0)
   })
 
+  it('Img tag with aria-hidden="true" and no alt attribute should not result in an error', () => {
+    const code = '<img width="200" height="300" aria-hidden="true">'
+    const messages = HTMLHint.verify(code, ruleOptions)
+    expect(messages.length).toBe(0)
+  })
+
+  it('Img tag with aria-hidden="TRUE" and no alt attribute should not result in an error', () => {
+    const code = '<img width="200" height="300" aria-hidden="TRUE">'
+    const messages = HTMLHint.verify(code, ruleOptions)
+    expect(messages.length).toBe(0)
+  })
+
+  it('Img tag with aria-hidden=" true " and no alt attribute should not result in an error', () => {
+    const code = '<img width="200" height="300" aria-hidden=" true ">'
+    const messages = HTMLHint.verify(code, ruleOptions)
+    expect(messages.length).toBe(0)
+  })
+
+  it('Img tag with aria-hidden="false" and no alt attribute should result in an error', () => {
+    const code = '<img width="200" height="300" aria-hidden="false">'
+    const messages = HTMLHint.verify(code, ruleOptions)
+    expect(messages.length).toBe(1)
+    expect(messages[0].rule.id).toBe(ruleId)
+    expect(messages[0].line).toBe(1)
+    expect(messages[0].col).toBe(5)
+    expect(messages[0].type).toBe('warning')
+  })
+
   it('Img tag have not alt attribute should result in an error', () => {
     const code = '<img width="200" height="300">'
     const messages = HTMLHint.verify(code, ruleOptions)
diff --git a/website/src/content/docs/rules/alt-require.mdx b/website/src/content/docs/rules/alt-require.mdx
index 85566c90d..3dc41ab91 100644
--- a/website/src/content/docs/rules/alt-require.mdx
+++ b/website/src/content/docs/rules/alt-require.mdx
@@ -10,7 +10,7 @@ keywords:
 
 import { Badge } from '@astrojs/starlight/components';
 
-Alt of `img` must be present and alt of `area[href]` and `input[type=image]` must be set with a value.
+Alt of `img` must be present unless the image is hidden from assistive technologies with `aria-hidden="true"`. Alt of `area[href]` and `input[type=image]` must be set with a value.
 
 Level: <Badge text="Warning" variant="caution" />
 
@@ -23,6 +23,7 @@ Level: <Badge text="Warning" variant="caution" />
 
 ```html
 <img src="test.png" alt="test" />
+<img src="decorative.png" aria-hidden="true" />
 <input type="image" alt="test" />
 <area shape="circle" coords="180,139,14" href="test.html" alt="test" />
 ```