diff --git a/src/binary.ts b/src/binary.ts
index 9121051d..065954e2 100644
--- a/src/binary.ts
+++ b/src/binary.ts
@@ -1,6 +1,7 @@
 import { Buffer } from 'buffer';
 import { ensureBuffer } from './ensure_buffer';
 import type { EJSONOptions } from './extended_json';
+import { parseUUID, UUIDExtended } from './uuid';
 
 type BinarySequence = Uint8Array | Buffer | number[];
 
@@ -223,20 +224,25 @@ export class Binary {
 
   /** @internal */
   static fromExtendedJSON(
-    doc: BinaryExtendedLegacy | BinaryExtended,
+    doc: BinaryExtendedLegacy | BinaryExtended | UUIDExtended,
     options?: EJSONOptions
   ): Binary {
     options = options || {};
     let data: Buffer | undefined;
     let type;
-    if (options.legacy && typeof doc.$binary === 'string' && '$type' in doc) {
-      type = doc.$type ? parseInt(doc.$type, 16) : 0;
-      data = Buffer.from(doc.$binary, 'base64');
-    } else {
-      if (typeof doc.$binary !== 'string') {
-        type = doc.$binary.subType ? parseInt(doc.$binary.subType, 16) : 0;
-        data = Buffer.from(doc.$binary.base64, 'base64');
+    if ('$binary' in doc) {
+      if (options.legacy && typeof doc.$binary === 'string' && '$type' in doc) {
+        type = doc.$type ? parseInt(doc.$type, 16) : 0;
+        data = Buffer.from(doc.$binary, 'base64');
+      } else {
+        if (typeof doc.$binary !== 'string') {
+          type = doc.$binary.subType ? parseInt(doc.$binary.subType, 16) : 0;
+          data = Buffer.from(doc.$binary.base64, 'base64');
+        }
       }
+    } else if ('$uuid' in doc) {
+      type = 4;
+      data = Buffer.from(parseUUID(doc.$uuid));
     }
     if (!data) {
       throw new TypeError(`Unexpected Binary Extended JSON format ${JSON.stringify(doc)}`);
diff --git a/src/extended_json.ts b/src/extended_json.ts
index 439ce484..d3447c66 100644
--- a/src/extended_json.ts
+++ b/src/extended_json.ts
@@ -52,6 +52,7 @@ export interface EJSONOptions {
 const keysToCodecs = {
   $oid: ObjectId,
   $binary: Binary,
+  $uuid: Binary,
   $symbol: BSONSymbol,
   $numberInt: Int32,
   $numberDecimal: Decimal128,
diff --git a/src/uuid.ts b/src/uuid.ts
new file mode 100644
index 00000000..5ea9d6d4
--- /dev/null
+++ b/src/uuid.ts
@@ -0,0 +1,56 @@
+/**
+ * UUID regular expression pattern copied from `uuid` npm module.
+ * @see https://github.com/uuidjs/uuid/blob/master/src/regex.js
+ */
+const UUID_RX = /^(?:[0-9a-f]{8}-[0-9a-f]{4}-[1-5][0-9a-f]{3}-[89ab][0-9a-f]{3}-[0-9a-f]{12}|00000000-0000-0000-0000-000000000000)$/i;
+
+export interface UUIDExtended {
+  $uuid: string;
+}
+
+/**
+ * Parser function copied from `uuid` npm module.
+ * @see https://github.com/uuidjs/uuid/blob/master/src/parse.js
+ * @internal
+ */
+export function parseUUID(uuid: string): Uint8Array {
+  if (typeof uuid !== 'string') {
+    throw new TypeError('Invalid type for UUID, expected string but got ' + typeof uuid);
+  }
+
+  if (!UUID_RX.test(uuid)) {
+    throw new TypeError('Invalid format for UUID: ' + uuid);
+  }
+
+  let v;
+  const arr = new Uint8Array(16);
+
+  // Parse ########-....-....-....-............
+  arr[0] = (v = parseInt(uuid.slice(0, 8), 16)) >>> 24;
+  arr[1] = (v >>> 16) & 0xff;
+  arr[2] = (v >>> 8) & 0xff;
+  arr[3] = v & 0xff;
+
+  // Parse ........-####-....-....-............
+  arr[4] = (v = parseInt(uuid.slice(9, 13), 16)) >>> 8;
+  arr[5] = v & 0xff;
+
+  // Parse ........-....-####-....-............
+  arr[6] = (v = parseInt(uuid.slice(14, 18), 16)) >>> 8;
+  arr[7] = v & 0xff;
+
+  // Parse ........-....-....-####-............
+  arr[8] = (v = parseInt(uuid.slice(19, 23), 16)) >>> 8;
+  arr[9] = v & 0xff;
+
+  // Parse ........-....-....-....-############
+  // (Use "/" to avoid 32-bit truncation when bit-shifting high-order bytes)
+  arr[10] = ((v = parseInt(uuid.slice(24, 36), 16)) / 0x10000000000) & 0xff;
+  arr[11] = (v / 0x100000000) & 0xff;
+  arr[12] = (v >>> 24) & 0xff;
+  arr[13] = (v >>> 16) & 0xff;
+  arr[14] = (v >>> 8) & 0xff;
+  arr[15] = v & 0xff;
+
+  return arr;
+}
diff --git a/test/node/specs/bson-corpus/binary.json b/test/node/specs/bson-corpus/binary.json
index 90a15c1a..324c56ab 100644
--- a/test/node/specs/bson-corpus/binary.json
+++ b/test/node/specs/bson-corpus/binary.json
@@ -39,6 +39,12 @@
             "canonical_bson": "1D000000057800100000000473FFD26444B34C6990E8E7D1DFC035D400",
             "canonical_extjson": "{\"x\" : { \"$binary\" : {\"base64\" : \"c//SZESzTGmQ6OfR38A11A==\", \"subType\" : \"04\"}}}"
         },
+        {
+            "description": "subtype 0x04 UUID",
+            "canonical_bson": "1D000000057800100000000473FFD26444B34C6990E8E7D1DFC035D400",
+            "canonical_extjson": "{\"x\" : { \"$binary\" : {\"base64\" : \"c//SZESzTGmQ6OfR38A11A==\", \"subType\" : \"04\"}}}",
+            "degenerate_extjson": "{\"x\" : { \"$uuid\" : \"73ffd264-44b3-4c69-90e8-e7d1dfc035d4\"}}"
+        },
         {
             "description": "subtype 0x05",
             "canonical_bson": "1D000000057800100000000573FFD26444B34C6990E8E7D1DFC035D400",
@@ -81,5 +87,15 @@
             "description": "subtype 0x02 length negative one",
             "bson": "130000000578000600000002FFFFFFFFFFFF00"
         }
+    ],
+    "parseErrors": [
+        {
+            "description": "$uuid wrong type",
+            "string": "{\"x\" : { \"$uuid\" : { \"data\" : \"73ffd264-44b3-4c69-90e8-e7d1dfc035d4\"}}}"
+        },
+        {
+            "description": "$uuid invalid value",
+            "string": "{\"x\" : { \"$uuid\" : \"73ffd264-44b3-90e8-e7d1dfc035d4\"}}"
+        }
     ]
 }