diff --git a/src/duckstation-qt/gamepropertiesdialog.cpp b/src/duckstation-qt/gamepropertiesdialog.cpp
index a68e87ed5..b5c096022 100644
--- a/src/duckstation-qt/gamepropertiesdialog.cpp
+++ b/src/duckstation-qt/gamepropertiesdialog.cpp
@@ -135,6 +135,9 @@ void GamePropertiesDialog::setupAdditionalUi()
   m_ui.userResolutionScale->addItem(tr("(unchanged)"));
   QtUtils::FillComboBoxWithResolutionScales(m_ui.userResolutionScale);
 
+  m_ui.userMSAAMode->addItem(tr("(unchanged)"));
+  QtUtils::FillComboBoxWithMSAAModes(m_ui.userMSAAMode);
+
   m_ui.userTextureFiltering->addItem(tr("(unchanged)"));
   for (u32 i = 0; i < static_cast<u32>(GPUTextureFilter::Count); i++)
   {
@@ -307,6 +310,11 @@ void GamePropertiesDialog::populateGameSettings()
     QSignalBlocker sb(m_ui.gpuMaxRunAhead);
     m_ui.gpuMaxRunAhead->setValue(static_cast<int>(gs.gpu_max_run_ahead.value()));
   }
+  if (gs.gpu_pgxp_tolerance.has_value())
+  {
+    QSignalBlocker sb(m_ui.gpuPGXPTolerance);
+    m_ui.gpuPGXPTolerance->setValue(static_cast<double>(gs.gpu_pgxp_tolerance.value()));
+  }
 
   if (gs.display_crop_mode.has_value())
   {
@@ -333,6 +341,21 @@ void GamePropertiesDialog::populateGameSettings()
     m_ui.userResolutionScale->setCurrentIndex(0);
   }
 
+  if (gs.gpu_multisamples.has_value() && gs.gpu_per_sample_shading.has_value())
+  {
+    QSignalBlocker sb(m_ui.userMSAAMode);
+    const QVariant current_msaa_mode(
+      QtUtils::GetMSAAModeValue(static_cast<uint>(gs.gpu_multisamples.value()), gs.gpu_per_sample_shading.has_value()));
+    const int current_msaa_index = m_ui.userMSAAMode->findData(current_msaa_mode);
+    if (current_msaa_index >= 0)
+      m_ui.userMSAAMode->setCurrentIndex((current_msaa_index >= 0) ? current_msaa_index : 0);
+  }
+  else
+  {
+    QSignalBlocker sb(m_ui.userMSAAMode);
+    m_ui.userMSAAMode->setCurrentIndex(0);
+  }
+
   if (gs.gpu_texture_filter.has_value())
   {
     QSignalBlocker sb(m_ui.userTextureFiltering);
@@ -497,6 +520,23 @@ void GamePropertiesDialog::connectUi()
     saveGameSettings();
   });
 
+  connect(m_ui.userMSAAMode, QOverload<int>::of(&QComboBox::currentIndexChanged), [this](int index) {
+    if (index == 0)
+    {
+      m_game_settings.gpu_multisamples.reset();
+      m_game_settings.gpu_per_sample_shading.reset();
+    }
+    else
+    {
+      uint multisamples;
+      bool ssaa;
+      QtUtils::DecodeMSAAModeValue(m_ui.userMSAAMode->itemData(index), &multisamples, &ssaa);
+      m_game_settings.gpu_multisamples = static_cast<u32>(multisamples);
+      m_game_settings.gpu_per_sample_shading = ssaa;
+    }
+    saveGameSettings();
+  });
+
   connect(m_ui.userTextureFiltering, QOverload<int>::of(&QComboBox::currentIndexChanged), [this](int index) {
     if (index <= 0)
       m_game_settings.gpu_texture_filter.reset();
@@ -633,6 +673,13 @@ void GamePropertiesDialog::connectUi()
       m_game_settings.gpu_max_run_ahead = static_cast<u32>(value);
     saveGameSettings();
   });
+  connect(m_ui.gpuPGXPTolerance, QOverload<double>::of(&QDoubleSpinBox::valueChanged), [this](double value) {
+    if (value < 0.0)
+      m_game_settings.gpu_pgxp_tolerance.reset();
+    else
+      m_game_settings.gpu_pgxp_tolerance = static_cast<float>(value);
+    saveGameSettings();
+  });
 }
 
 void GamePropertiesDialog::updateCPUClockSpeedLabel()
diff --git a/src/duckstation-qt/gamepropertiesdialog.ui b/src/duckstation-qt/gamepropertiesdialog.ui
index 9709c859e..00cafef5e 100644
--- a/src/duckstation-qt/gamepropertiesdialog.ui
+++ b/src/duckstation-qt/gamepropertiesdialog.ui
@@ -325,16 +325,26 @@
            <widget class="QComboBox" name="userResolutionScale"/>
           </item>
           <item row="1" column="0">
+           <widget class="QLabel" name="label_24">
+            <property name="text">
+             <string>Multisample Antialiasing:</string>
+            </property>
+           </widget>
+          </item>
+          <item row="1" column="1">
+           <widget class="QComboBox" name="userMSAAMode"/>
+          </item>
+          <item row="2" column="0">
            <widget class="QLabel" name="label_23">
             <property name="text">
              <string>Texture Filtering:</string>
             </property>
            </widget>
           </item>
-          <item row="1" column="1">
+          <item row="2" column="1">
            <widget class="QComboBox" name="userTextureFiltering"/>
           </item>
-          <item row="2" column="0" colspan="2">
+          <item row="3" column="0" colspan="2">
            <layout class="QGridLayout" name="gridLayout">
             <item row="0" column="0">
              <widget class="QCheckBox" name="userTrueColor">
@@ -741,6 +751,29 @@
             </property>
            </widget>
           </item>
+          <item row="5" column="0">
+           <widget class="QLabel" name="label_28">
+            <property name="text">
+             <string>PGXP Geometry Tolerance:</string>
+            </property>
+           </widget>
+          </item>
+          <item row="5" column="1">
+           <widget class="QDoubleSpinBox" name="gpuPGXPTolerance">
+            <property name="minimum">
+             <number>-1</number>
+            </property>
+            <property name="maximum">
+             <number>10</number>
+            </property>
+            <property name="singleStep">
+             <number>0.5</number>
+            </property>
+            <property name="value">
+             <number>-1</number>
+            </property>
+           </widget>
+          </item>
          </layout>
         </widget>
        </item>
diff --git a/src/frontend-common/game_list.h b/src/frontend-common/game_list.h
index 39c268737..428aa27f5 100644
--- a/src/frontend-common/game_list.h
+++ b/src/frontend-common/game_list.h
@@ -115,7 +115,7 @@ private:
   enum : u32
   {
     GAME_LIST_CACHE_SIGNATURE = 0x45434C47,
-    GAME_LIST_CACHE_VERSION = 14
+    GAME_LIST_CACHE_VERSION = 15
   };
 
   using DatabaseMap = std::unordered_map<std::string, GameListDatabaseEntry>;
diff --git a/src/frontend-common/game_settings.cpp b/src/frontend-common/game_settings.cpp
index 0d824e42b..533f6b47e 100644
--- a/src/frontend-common/game_settings.cpp
+++ b/src/frontend-common/game_settings.cpp
@@ -111,11 +111,13 @@ bool Entry::LoadFromStream(ByteStream* stream)
       !ReadOptionalFromStream(stream, &display_active_end_offset) ||
       !ReadOptionalFromStream(stream, &dma_max_slice_ticks) || !ReadOptionalFromStream(stream, &dma_halt_ticks) ||
       !ReadOptionalFromStream(stream, &gpu_fifo_size) || !ReadOptionalFromStream(stream, &gpu_max_run_ahead) ||
-      !ReadOptionalFromStream(stream, &display_crop_mode) || !ReadOptionalFromStream(stream, &display_aspect_ratio) ||
+      !ReadOptionalFromStream(stream, &gpu_pgxp_tolerance) || !ReadOptionalFromStream(stream, &display_crop_mode) ||
+      !ReadOptionalFromStream(stream, &display_aspect_ratio) ||
       !ReadOptionalFromStream(stream, &display_linear_upscaling) ||
       !ReadOptionalFromStream(stream, &display_integer_upscaling) ||
       !ReadOptionalFromStream(stream, &display_force_4_3_for_24bit) ||
-      !ReadOptionalFromStream(stream, &gpu_resolution_scale) || !ReadOptionalFromStream(stream, &gpu_true_color) ||
+      !ReadOptionalFromStream(stream, &gpu_resolution_scale) || !ReadOptionalFromStream(stream, &gpu_multisamples) ||
+      !ReadOptionalFromStream(stream, &gpu_per_sample_shading) || !ReadOptionalFromStream(stream, &gpu_true_color) ||
       !ReadOptionalFromStream(stream, &gpu_scaled_dithering) ||
       !ReadOptionalFromStream(stream, &gpu_force_ntsc_timings) ||
       !ReadOptionalFromStream(stream, &gpu_texture_filter) || !ReadOptionalFromStream(stream, &gpu_widescreen_hack) ||
@@ -156,11 +158,13 @@ bool Entry::SaveToStream(ByteStream* stream) const
          WriteOptionalToStream(stream, display_active_end_offset) &&
          WriteOptionalToStream(stream, dma_max_slice_ticks) && WriteOptionalToStream(stream, dma_halt_ticks) &&
          WriteOptionalToStream(stream, gpu_fifo_size) && WriteOptionalToStream(stream, gpu_max_run_ahead) &&
-         WriteOptionalToStream(stream, display_crop_mode) && WriteOptionalToStream(stream, display_aspect_ratio) &&
+         WriteOptionalToStream(stream, gpu_pgxp_tolerance) && WriteOptionalToStream(stream, display_crop_mode) &&
+         WriteOptionalToStream(stream, display_aspect_ratio) &&
          WriteOptionalToStream(stream, display_linear_upscaling) &&
          WriteOptionalToStream(stream, display_integer_upscaling) &&
          WriteOptionalToStream(stream, display_force_4_3_for_24bit) &&
-         WriteOptionalToStream(stream, gpu_resolution_scale) && WriteOptionalToStream(stream, gpu_true_color) &&
+         WriteOptionalToStream(stream, gpu_resolution_scale) && WriteOptionalToStream(stream, gpu_multisamples) &&
+         WriteOptionalToStream(stream, gpu_per_sample_shading) && WriteOptionalToStream(stream, gpu_true_color) &&
          WriteOptionalToStream(stream, gpu_scaled_dithering) && WriteOptionalToStream(stream, gpu_force_ntsc_timings) &&
          WriteOptionalToStream(stream, gpu_texture_filter) && WriteOptionalToStream(stream, gpu_widescreen_hack) &&
          WriteOptionalToStream(stream, gpu_pgxp) && WriteOptionalToStream(stream, controller_1_type) &&
@@ -209,6 +213,9 @@ static void ParseIniSection(Entry* entry, const char* section, const CSimpleIniA
   lvalue = ini.GetLongValue(section, "GPUMaxRunAhead", 0);
   if (lvalue > 0)
     entry->gpu_max_run_ahead = static_cast<u32>(lvalue);
+  float fvalue = static_cast<float>(ini.GetDoubleValue(section, "GPUPGXPTolerance", -1.0f));
+  if (fvalue >= 0.0f)
+    entry->gpu_pgxp_tolerance = fvalue;
 
   cvalue = ini.GetValue(section, "DisplayCropMode", nullptr);
   if (cvalue)
@@ -229,6 +236,12 @@ static void ParseIniSection(Entry* entry, const char* section, const CSimpleIniA
   cvalue = ini.GetValue(section, "GPUResolutionScale", nullptr);
   if (cvalue)
     entry->gpu_resolution_scale = StringUtil::FromChars<u32>(cvalue);
+  cvalue = ini.GetValue(section, "GPUMultisamples", nullptr);
+  if (cvalue)
+    entry->gpu_multisamples = StringUtil::FromChars<u32>(cvalue);
+  cvalue = ini.GetValue(section, "GPUPerSampleShading", nullptr);
+  if (cvalue)
+    entry->gpu_per_sample_shading = StringUtil::FromChars<bool>(cvalue);
   cvalue = ini.GetValue(section, "GPUTrueColor", nullptr);
   if (cvalue)
     entry->gpu_true_color = StringUtil::FromChars<bool>(cvalue);
@@ -302,6 +315,8 @@ static void StoreIniSection(const Entry& entry, const char* section, CSimpleIniA
     ini.SetLongValue(section, "GPUFIFOSize", static_cast<long>(entry.gpu_fifo_size.value()));
   if (entry.gpu_max_run_ahead.has_value())
     ini.SetLongValue(section, "GPUMaxRunAhead", static_cast<long>(entry.gpu_max_run_ahead.value()));
+  if (entry.gpu_pgxp_tolerance.has_value())
+    ini.SetDoubleValue(section, "GPUPGXPTolerance", static_cast<double>(entry.gpu_pgxp_tolerance.value()));
 
   if (entry.display_crop_mode.has_value())
     ini.SetValue(section, "DisplayCropMode", Settings::GetDisplayCropModeName(entry.display_crop_mode.value()));
@@ -319,6 +334,10 @@ static void StoreIniSection(const Entry& entry, const char* section, CSimpleIniA
 
   if (entry.gpu_resolution_scale.has_value())
     ini.SetLongValue(section, "GPUResolutionScale", static_cast<s32>(entry.gpu_resolution_scale.value()));
+  if (entry.gpu_multisamples.has_value())
+    ini.SetLongValue(section, "GPUMultisamples", static_cast<s32>(entry.gpu_multisamples.value()));
+  if (entry.gpu_per_sample_shading.has_value())
+    ini.SetValue(section, "GPUPerSampleShading", entry.gpu_per_sample_shading.value() ? "true" : "false");
   if (entry.gpu_true_color.has_value())
     ini.SetValue(section, "GPUTrueColor", entry.gpu_true_color.value() ? "true" : "false");
   if (entry.gpu_scaled_dithering.has_value())
@@ -475,6 +494,8 @@ void Entry::ApplySettings(bool display_osd_messages) const
     g_settings.gpu_fifo_size = gpu_fifo_size.value();
   if (gpu_max_run_ahead.has_value())
     g_settings.gpu_max_run_ahead = gpu_max_run_ahead.value();
+  if (gpu_pgxp_tolerance.has_value())
+    g_settings.gpu_pgxp_tolerance = gpu_pgxp_tolerance.value();
 
   if (display_crop_mode.has_value())
     g_settings.display_crop_mode = display_crop_mode.value();
@@ -489,6 +510,10 @@ void Entry::ApplySettings(bool display_osd_messages) const
 
   if (gpu_resolution_scale.has_value())
     g_settings.gpu_resolution_scale = gpu_resolution_scale.value();
+  if (gpu_multisamples.has_value())
+    g_settings.gpu_multisamples = gpu_multisamples.value();
+  if (gpu_per_sample_shading.has_value())
+    g_settings.gpu_per_sample_shading = gpu_per_sample_shading.value();
   if (gpu_true_color.has_value())
     g_settings.gpu_true_color = gpu_true_color.value();
   if (gpu_scaled_dithering.has_value())
diff --git a/src/frontend-common/game_settings.h b/src/frontend-common/game_settings.h
index 70e518313..590118341 100644
--- a/src/frontend-common/game_settings.h
+++ b/src/frontend-common/game_settings.h
@@ -42,6 +42,7 @@ struct Entry
   std::optional<u32> dma_halt_ticks;
   std::optional<u32> gpu_fifo_size;
   std::optional<u32> gpu_max_run_ahead;
+  std::optional<float> gpu_pgxp_tolerance;
 
   // user settings
   std::optional<u32> cpu_overclock_numerator;
@@ -54,6 +55,8 @@ struct Entry
   std::optional<bool> display_integer_upscaling;
   std::optional<bool> display_force_4_3_for_24bit;
   std::optional<u32> gpu_resolution_scale;
+  std::optional<u32> gpu_multisamples;
+  std::optional<bool> gpu_per_sample_shading;
   std::optional<bool> gpu_true_color;
   std::optional<bool> gpu_scaled_dithering;
   std::optional<bool> gpu_force_ntsc_timings;