diff --git a/crates/ruff_linter/resources/test/fixtures/pylint/dict_iter_missing_items.py b/crates/ruff_linter/resources/test/fixtures/pylint/dict_iter_missing_items.py
index 18a5037c8365b..4f850f267db15 100644
--- a/crates/ruff_linter/resources/test/fixtures/pylint/dict_iter_missing_items.py
+++ b/crates/ruff_linter/resources/test/fixtures/pylint/dict_iter_missing_items.py
@@ -1,5 +1,10 @@
+from typing import Any
+
+
 d = {1: 1, 2: 2}
 d_tuple = {(1, 2): 3, (4, 5): 6}
+d_tuple_annotated: Any = {(1, 2): 3, (4, 5): 6}
+d_tuple_incorrect_tuple = {(1,): 3, (4, 5): 6}
 l = [1, 2]
 s1 = {1, 2}
 s2 = {1, 2, 3}
@@ -8,10 +13,10 @@
 for k, v in d:
     pass
 
-# False positive, since the keys are all tuples this is valid
-for a, b in d_tuple: 
+for k, v in d_tuple_incorrect_tuple:
     pass
 
+
 # Non errors
 for k, v in d.items():
     pass
@@ -21,3 +26,7 @@
     pass
 for i, v in s1.intersection(s2):
     pass
+for a, b in d_tuple: 
+    pass
+for a, b in d_tuple_annotated: 
+    pass
diff --git a/crates/ruff_linter/src/rules/pylint/rules/dict_iter_missing_items.rs b/crates/ruff_linter/src/rules/pylint/rules/dict_iter_missing_items.rs
index 310859b0e36f9..f73b62bf73b8b 100644
--- a/crates/ruff_linter/src/rules/pylint/rules/dict_iter_missing_items.rs
+++ b/crates/ruff_linter/src/rules/pylint/rules/dict_iter_missing_items.rs
@@ -65,6 +65,24 @@ pub(crate) fn dict_iter_missing_items(checker: &mut Checker, target: &Expr, iter
         return;
     }
 
+    // If we can reliably determine that a dictionary has keys that are tuples of two we don't warn
+    if let Some(statement) = binding.statement(checker.semantic()) {
+        if let Some(assignment) = statement.as_assign_stmt() {
+            if let Some(dict_expr) = assignment.value.as_dict_expr() {
+                if dict_expr.keys.iter().all(|elt| {
+                    elt.as_ref().is_some_and(|x| {
+                        if let Some(tuple) = x.as_tuple_expr() {
+                            return tuple.elts.len() == 2;
+                        }
+                        false
+                    })
+                }) {
+                    return;
+                }
+            }
+        }
+    };
+
     let mut diagnostic = Diagnostic::new(DictIterMissingItems, iter.range());
     diagnostic.set_fix(Fix::safe_edit(Edit::range_replacement(
         format!("{}.items()", name.id),
diff --git a/crates/ruff_linter/src/rules/pylint/snapshots/ruff_linter__rules__pylint__tests__PLE1141_dict_iter_missing_items.py.snap b/crates/ruff_linter/src/rules/pylint/snapshots/ruff_linter__rules__pylint__tests__PLE1141_dict_iter_missing_items.py.snap
index f2bd51eda5fba..15f2e1295a625 100644
--- a/crates/ruff_linter/src/rules/pylint/snapshots/ruff_linter__rules__pylint__tests__PLE1141_dict_iter_missing_items.py.snap
+++ b/crates/ruff_linter/src/rules/pylint/snapshots/ruff_linter__rules__pylint__tests__PLE1141_dict_iter_missing_items.py.snap
@@ -1,42 +1,43 @@
 ---
 source: crates/ruff_linter/src/rules/pylint/mod.rs
 ---
-dict_iter_missing_items.py:8:13: PLE1141 [*] Call `items()` when unpacking a dictionary for iteration
-  |
-7 | # Errors
-8 | for k, v in d:
-  |             ^ PLE1141
-9 |     pass
-  |
-  = help: Add a call to `.items()`
+dict_iter_missing_items.py:13:13: PLE1141 [*] Call `items()` when unpacking a dictionary for iteration
+   |
+12 | # Errors
+13 | for k, v in d:
+   |             ^ PLE1141
+14 |     pass
+   |
+   = help: Add a call to `.items()`
 
 ℹ Safe fix
-5 5 | s2 = {1, 2, 3}
-6 6 | 
-7 7 | # Errors
-8   |-for k, v in d:
-  8 |+for k, v in d.items():
-9 9 |     pass
-10 10 | 
-11 11 | # False positive, since the keys are all tuples this is valid
+10 10 | s2 = {1, 2, 3}
+11 11 | 
+12 12 | # Errors
+13    |-for k, v in d:
+   13 |+for k, v in d.items():
+14 14 |     pass
+15 15 | 
+16 16 | for k, v in d_tuple_incorrect_tuple:
 
-dict_iter_missing_items.py:12:13: PLE1141 [*] Call `items()` when unpacking a dictionary for iteration
+dict_iter_missing_items.py:16:13: PLE1141 [*] Call `items()` when unpacking a dictionary for iteration
    |
-11 | # False positive, since the keys are all tuples this is valid
-12 | for a, b in d_tuple: 
-   |             ^^^^^^^ PLE1141
-13 |     pass
+14 |     pass
+15 | 
+16 | for k, v in d_tuple_incorrect_tuple:
+   |             ^^^^^^^^^^^^^^^^^^^^^^^ PLE1141
+17 |     pass
    |
    = help: Add a call to `.items()`
 
 ℹ Safe fix
-9  9  |     pass
-10 10 | 
-11 11 | # False positive, since the keys are all tuples this is valid
-12    |-for a, b in d_tuple: 
-   12 |+for a, b in d_tuple.items(): 
-13 13 |     pass
-14 14 | 
-15 15 | # Non errors
+13 13 | for k, v in d:
+14 14 |     pass
+15 15 | 
+16    |-for k, v in d_tuple_incorrect_tuple:
+   16 |+for k, v in d_tuple_incorrect_tuple.items():
+17 17 |     pass
+18 18 | 
+19 19 |