diff --git a/src/common/audio_stream.cpp b/src/common/audio_stream.cpp
new file mode 100644
index 000000000..1a2abff0a
--- /dev/null
+++ b/src/common/audio_stream.cpp
@@ -0,0 +1,201 @@
+#include "audio_stream.h"
+#include "YBaseLib/Assert.h"
+#include "YBaseLib/Log.h"
+Log_SetChannel(Audio);
+
+AudioStream::AudioStream() = default;
+
+AudioStream::~AudioStream() = default;
+
+bool AudioStream::Reconfigure(u32 output_sample_rate /*= DefaultOutputSampleRate*/, u32 channels /*= 1*/,
+                              u32 buffer_size /*= DefaultBufferSize*/, u32 buffer_count /*= DefaultBufferCount*/)
+{
+  if (IsDeviceOpen())
+    CloseDevice();
+
+  m_output_sample_rate = output_sample_rate;
+  m_channels = channels;
+  m_buffer_size = buffer_size;
+  AllocateBuffers(buffer_count);
+  m_output_paused = true;
+
+  if (!OpenDevice())
+  {
+    EmptyBuffers();
+    m_buffers.clear();
+    m_buffer_size = 0;
+    m_output_sample_rate = 0;
+    m_channels = 0;
+    return false;
+  }
+
+  return true;
+}
+
+void AudioStream::PauseOutput(bool paused)
+{
+  if (m_output_paused == paused)
+    return;
+
+  PauseDevice(paused);
+  m_output_paused = paused;
+
+  // Empty buffers on pause.
+  if (paused)
+    EmptyBuffers();
+}
+
+void AudioStream::Shutdown()
+{
+  if (!IsDeviceOpen())
+    return;
+
+  CloseDevice();
+  EmptyBuffers();
+  m_buffers.clear();
+  m_buffer_size = 0;
+  m_output_sample_rate = 0;
+  m_channels = 0;
+  m_output_paused = true;
+}
+
+void AudioStream::BeginWrite(SampleType** buffer_ptr, u32* num_samples)
+{
+  m_buffer_lock.lock();
+
+  if (m_num_free_buffers == 0)
+    DropBuffer();
+
+  Buffer& buffer = m_buffers[m_first_free_buffer];
+  *buffer_ptr = buffer.data.data() + buffer.write_position;
+  *num_samples = m_buffer_size - buffer.write_position;
+}
+
+void AudioStream::WriteSamples(const SampleType* samples, u32 num_samples)
+{
+  std::lock_guard<std::mutex> guard(m_buffer_lock);
+  u32 remaining_samples = num_samples;
+
+  while (remaining_samples > 0)
+  {
+    if (m_num_free_buffers == 0)
+      DropBuffer();
+
+    Buffer& buffer = m_buffers[m_first_free_buffer];
+    const u32 to_this_buffer = std::min(m_buffer_size - buffer.write_position, remaining_samples);
+
+    const u32 copy_count = to_this_buffer * m_channels;
+    std::memcpy(&buffer.data[buffer.write_position * m_channels], samples, copy_count * sizeof(SampleType));
+    samples += copy_count;
+
+    remaining_samples -= to_this_buffer;
+    buffer.write_position += to_this_buffer;
+
+    // End of the buffer?
+    if (buffer.write_position == m_buffer_size)
+    {
+      // Reset it back to the start, and enqueue it.
+      buffer.write_position = 0;
+      m_num_free_buffers--;
+      m_first_free_buffer = (m_first_free_buffer + 1) % m_buffers.size();
+      m_num_available_buffers++;
+    }
+  }
+}
+
+void AudioStream::EndWrite(u32 num_samples)
+{
+  Buffer& buffer = m_buffers[m_first_free_buffer];
+  DebugAssert((buffer.write_position + num_samples) <= m_buffer_size);
+  buffer.write_position += num_samples;
+
+  // End of the buffer?
+  if (buffer.write_position == m_buffer_size)
+  {
+    // Reset it back to the start, and enqueue it.
+    // Log_DevPrintf("Enqueue buffer %u", m_first_free_buffer);
+    buffer.write_position = 0;
+    m_num_free_buffers--;
+    m_first_free_buffer = (m_first_free_buffer + 1) % m_buffers.size();
+    m_num_available_buffers++;
+  }
+
+  m_buffer_lock.unlock();
+}
+
+u32 AudioStream::ReadSamples(SampleType* samples, u32 num_samples)
+{
+  std::lock_guard<std::mutex> guard(m_buffer_lock);
+  u32 remaining_samples = num_samples;
+
+  while (remaining_samples > 0 && m_num_available_buffers > 0)
+  {
+    Buffer& buffer = m_buffers[m_first_available_buffer];
+    const u32 from_this_buffer = std::min(m_buffer_size - buffer.read_position, remaining_samples);
+
+    const u32 copy_count = from_this_buffer * m_channels;
+    std::memcpy(samples, &buffer.data[buffer.read_position * m_channels], copy_count * sizeof(SampleType));
+    samples += copy_count;
+
+    remaining_samples -= from_this_buffer;
+    buffer.read_position += from_this_buffer;
+
+    if (buffer.read_position == m_buffer_size)
+    {
+      // Log_DevPrintf("Finish dequeing buffer %u", m_first_available_buffer);
+      // End of this buffer.
+      buffer.read_position = 0;
+      m_num_available_buffers--;
+      m_first_available_buffer = (m_first_available_buffer + 1) % m_buffers.size();
+      m_num_free_buffers++;
+    }
+  }
+
+  return num_samples - remaining_samples;
+}
+
+void AudioStream::AllocateBuffers(u32 buffer_count)
+{
+  m_buffers.resize(buffer_count);
+  for (u32 i = 0; i < buffer_count; i++)
+  {
+    Buffer& buffer = m_buffers[i];
+    buffer.data.resize(m_buffer_size * m_channels);
+    buffer.read_position = 0;
+    buffer.write_position = 0;
+  }
+
+  m_first_available_buffer = 0;
+  m_num_available_buffers = 0;
+  m_first_free_buffer = 0;
+  m_num_free_buffers = buffer_count;
+}
+
+void AudioStream::DropBuffer()
+{
+  DebugAssert(m_num_available_buffers > 0);
+  // Log_DevPrintf("Dropping buffer %u", m_first_free_buffer);
+
+  // Out of space. We'll overwrite the oldest buffer with the new data.
+  // At the same time, we shift the available buffer forward one.
+  m_first_available_buffer = (m_first_available_buffer + 1) % m_buffers.size();
+  m_num_available_buffers--;
+
+  m_buffers[m_first_free_buffer].read_position = 0;
+  m_buffers[m_first_free_buffer].write_position = 0;
+  m_num_free_buffers++;
+}
+
+void AudioStream::EmptyBuffers()
+{
+  for (Buffer& buffer : m_buffers)
+  {
+    buffer.read_position = 0;
+    buffer.write_position = 0;
+  }
+
+  m_first_free_buffer = 0;
+  m_num_free_buffers = static_cast<u32>(m_buffers.size());
+  m_first_available_buffer = 0;
+  m_num_available_buffers = 0;
+}
diff --git a/src/common/audio_stream.h b/src/common/audio_stream.h
new file mode 100644
index 000000000..c502d6b28
--- /dev/null
+++ b/src/common/audio_stream.h
@@ -0,0 +1,77 @@
+#pragma once
+#include "types.h"
+#include <memory>
+#include <mutex>
+#include <vector>
+
+// Uses signed 16-bits samples.
+
+class AudioStream
+{
+public:
+  using SampleType = s16;
+
+  enum
+  {
+    DefaultOutputSampleRate = 44100,
+    DefaultBufferSize = 2048,
+    DefaultBufferCount = 3,
+  };
+
+  AudioStream();
+  virtual ~AudioStream();
+
+  u32 GetOutputSampleRate() const { return m_output_sample_rate; }
+  u32 GetChannels() const { return m_channels; }
+  u32 GetBufferSize() const { return m_buffer_size; }
+  u32 GetBufferCount() const { return static_cast<u32>(m_buffers.size()); }
+
+  bool Reconfigure(u32 output_sample_rate = DefaultOutputSampleRate, u32 channels = 1,
+                   u32 buffer_size = DefaultBufferSize, u32 buffer_count = DefaultBufferCount);
+
+  void PauseOutput(bool paused);
+  void EmptyBuffers();
+
+  void Shutdown();
+
+  void BeginWrite(SampleType** buffer_ptr, u32* num_samples);
+  void WriteSamples(const SampleType* samples, u32 num_samples);
+  void EndWrite(u32 num_samples);
+
+protected:
+  virtual bool OpenDevice() = 0;
+  virtual void PauseDevice(bool paused) = 0;
+  virtual void CloseDevice() = 0;
+
+  bool IsDeviceOpen() const { return (m_output_sample_rate > 0); }
+
+  u32 ReadSamples(SampleType* samples, u32 num_samples);
+
+  u32 m_output_sample_rate = 0;
+  u32 m_channels = 0;
+  u32 m_buffer_size = 0;
+
+private:
+  struct Buffer
+  {
+    std::vector<SampleType> data;
+    u32 write_position;
+    u32 read_position;
+  };
+
+  void AllocateBuffers(u32 buffer_count);
+  void DropBuffer();
+
+  std::vector<Buffer> m_buffers;
+  std::mutex m_buffer_lock;
+
+  // For input.
+  u32 m_first_free_buffer = 0;
+  u32 m_num_free_buffers = 0;
+
+  // For output.
+  u32 m_num_available_buffers = 0;
+  u32 m_first_available_buffer = 0;
+
+  bool m_output_paused = true;
+};
\ No newline at end of file
diff --git a/src/common/common.vcxproj b/src/common/common.vcxproj
index 7b61e3387..00a68ed71 100644
--- a/src/common/common.vcxproj
+++ b/src/common/common.vcxproj
@@ -36,6 +36,7 @@
   </ItemGroup>
   <ItemGroup>
     <ClInclude Include="audio.h" />
+    <ClInclude Include="audio_stream.h" />
     <ClInclude Include="bitfield.h" />
     <ClInclude Include="cd_image.h" />
     <ClInclude Include="display.h" />
@@ -58,6 +59,7 @@
   </ItemGroup>
   <ItemGroup>
     <ClCompile Include="audio.cpp" />
+    <ClCompile Include="audio_stream.cpp" />
     <ClCompile Include="cd_image.cpp" />
     <ClCompile Include="display.cpp" />
     <ClCompile Include="display_renderer_d3d.cpp" />
diff --git a/src/common/common.vcxproj.filters b/src/common/common.vcxproj.filters
index 92340bf5e..d98ca1c1a 100644
--- a/src/common/common.vcxproj.filters
+++ b/src/common/common.vcxproj.filters
@@ -21,6 +21,7 @@
     <ClInclude Include="gl_texture.h" />
     <ClInclude Include="fifo_queue.h" />
     <ClInclude Include="cd_image.h" />
+    <ClInclude Include="audio_stream.h" />
   </ItemGroup>
   <ItemGroup>
     <ClCompile Include="hdd_image.cpp" />
@@ -38,6 +39,7 @@
     <ClCompile Include="gl_program.cpp" />
     <ClCompile Include="gl_texture.cpp" />
     <ClCompile Include="cd_image.cpp" />
+    <ClCompile Include="audio_stream.cpp" />
   </ItemGroup>
   <ItemGroup>
     <Natvis Include="bitfield.natvis" />
diff --git a/src/duckstation/duckstation.vcxproj b/src/duckstation/duckstation.vcxproj
index e43390bfc..33edb6036 100644
--- a/src/duckstation/duckstation.vcxproj
+++ b/src/duckstation/duckstation.vcxproj
@@ -50,12 +50,14 @@
   </ItemGroup>
   <ItemGroup>
     <ClCompile Include="sdl_audio_mixer.cpp" />
+    <ClCompile Include="sdl_audio_stream.cpp" />
     <ClCompile Include="sdl_interface.cpp" />
     <ClCompile Include="main.cpp" />
   </ItemGroup>
   <ItemGroup>
     <ClInclude Include="icon.h" />
     <ClInclude Include="sdl_audio_mixer.h" />
+    <ClInclude Include="sdl_audio_stream.h" />
     <ClInclude Include="sdl_interface.h" />
   </ItemGroup>
   <PropertyGroup Label="Globals">
diff --git a/src/duckstation/duckstation.vcxproj.filters b/src/duckstation/duckstation.vcxproj.filters
index cd9a6b02b..60ebd5f6d 100644
--- a/src/duckstation/duckstation.vcxproj.filters
+++ b/src/duckstation/duckstation.vcxproj.filters
@@ -4,10 +4,12 @@
     <ClCompile Include="main.cpp" />
     <ClCompile Include="sdl_audio_mixer.cpp" />
     <ClCompile Include="sdl_interface.cpp" />
+    <ClCompile Include="sdl_audio_stream.cpp" />
   </ItemGroup>
   <ItemGroup>
     <ClInclude Include="sdl_audio_mixer.h" />
     <ClInclude Include="sdl_interface.h" />
     <ClInclude Include="icon.h" />
+    <ClInclude Include="sdl_audio_stream.h" />
   </ItemGroup>
 </Project>
\ No newline at end of file
diff --git a/src/duckstation/sdl_audio_stream.cpp b/src/duckstation/sdl_audio_stream.cpp
new file mode 100644
index 000000000..093eb7c70
--- /dev/null
+++ b/src/duckstation/sdl_audio_stream.cpp
@@ -0,0 +1,61 @@
+#include "sdl_audio_stream.h"
+#include "YBaseLib/Assert.h"
+#include "YBaseLib/Log.h"
+#include <SDL.h>
+Log_SetChannel(SDLAudioStream);
+
+SDLAudioStream::SDLAudioStream() = default;
+
+SDLAudioStream::~SDLAudioStream()
+{
+  if (m_is_open)
+    SDLAudioStream::CloseDevice();
+}
+
+bool SDLAudioStream::OpenDevice()
+{
+  DebugAssert(!m_is_open);
+
+  SDL_AudioSpec spec = {};
+  spec.freq = m_output_sample_rate;
+  spec.channels = m_channels;
+  spec.format = AUDIO_S16;
+  spec.samples = m_buffer_size;
+  spec.callback = AudioCallback;
+  spec.userdata = static_cast<void*>(this);
+
+  SDL_AudioSpec obtained = {};
+  if (SDL_OpenAudio(&spec, &obtained) < 0)
+  {
+    Log_ErrorPrintf("SDL_OpenAudio failed");
+    return false;
+  }
+
+  m_is_open = true;
+  return true;
+}
+
+void SDLAudioStream::PauseDevice(bool paused)
+{
+  SDL_PauseAudio(paused ? 1 : 0);
+}
+
+void SDLAudioStream::CloseDevice()
+{
+  DebugAssert(m_is_open);
+  SDL_CloseAudio();
+  m_is_open = false;
+}
+
+void SDLAudioStream::AudioCallback(void* userdata, uint8_t* stream, int len)
+{
+  SDLAudioStream* const this_ptr = static_cast<SDLAudioStream*>(userdata);
+  const u32 num_samples = len / sizeof(SampleType) / this_ptr->m_channels;
+  const u32 read_samples = this_ptr->ReadSamples(reinterpret_cast<SampleType*>(stream), num_samples);
+  const u32 silence_samples = num_samples - read_samples;
+  if (silence_samples > 0)
+  {
+    std::memset(reinterpret_cast<SampleType*>(stream) + (read_samples * this_ptr->m_channels), 0,
+                silence_samples * this_ptr->m_channels * sizeof(SampleType));
+  }
+}
diff --git a/src/duckstation/sdl_audio_stream.h b/src/duckstation/sdl_audio_stream.h
new file mode 100644
index 000000000..a3daf689c
--- /dev/null
+++ b/src/duckstation/sdl_audio_stream.h
@@ -0,0 +1,19 @@
+#pragma once
+#include "common/audio_stream.h"
+#include <cstdint>
+
+class SDLAudioStream final : public AudioStream
+{
+public:
+  SDLAudioStream();
+  ~SDLAudioStream();
+
+protected:
+  bool OpenDevice() override;
+  void PauseDevice(bool paused) override;
+  void CloseDevice() override;
+
+  static void AudioCallback(void* userdata, uint8_t* stream, int len);
+
+  bool m_is_open = false;
+};