diff --git a/datadog_checks_base/changelog.d/23530.added b/datadog_checks_base/changelog.d/23530.added
new file mode 100644
index 0000000000000..07aeeb425b1fe
--- /dev/null
+++ b/datadog_checks_base/changelog.d/23530.added
@@ -0,0 +1 @@
+Add a per-performance-object `include_total` option (default `false`) to the Windows perf-counter framework. When set to `true`, the `_Total` aggregate instance is collected instead of being excluded by default.
diff --git a/datadog_checks_base/datadog_checks/base/checks/windows/perf_counters/counter.py b/datadog_checks_base/datadog_checks/base/checks/windows/perf_counters/counter.py
index 553a92b9cfe33..d2d11b411f9d8 100644
--- a/datadog_checks_base/datadog_checks/base/checks/windows/perf_counters/counter.py
+++ b/datadog_checks_base/datadog_checks/base/checks/windows/perf_counters/counter.py
@@ -55,6 +55,16 @@ def __init__(self, check, connection, name, config, use_localized_counters, tags
             # See: https://learn.microsoft.com/en-us/windows/win32/perfctrs/about-performance-counters
             self.include_pattern = re.compile('|'.join(include_patterns), re.IGNORECASE)
 
+        # Opt in to collect the `_Total` aggregate instance, which is excluded by default because
+        # it is usually derivable from the per-instance values. Some perf objects (e.g.
+        # `MSExchangeTransport Queues`) report data on `_Total` that is not the sum of the
+        # visible instances, in which case excluding it loses information.
+        include_total = config.get('include_total', False)
+        if not isinstance(include_total, bool):
+            raise ConfigTypeError(
+                f'Option `include_total` for performance object `{self.name}` must be a boolean'
+            )
+
         # List of regex patterns to filter multi-instance counters AFTER ALL data
         # is collected and retrieved from PDH layer
         exclude_patterns = config.get('exclude', [])
@@ -67,11 +77,13 @@ def __init__(self, check, connection, name, config, use_localized_counters, tags
                         f'Pattern #{i} of option `exclude` for performance object `{self.name}` must be a string'
                     )
 
-            final_exclude_patterns = [r'\b_Total\b']
+            final_exclude_patterns = [] if include_total else [r'\b_Total\b']
             final_exclude_patterns.extend(exclude_patterns)
+            # `(?!)` is a never-matching pattern, used when there is nothing to exclude so that
+            # `self.exclude_pattern.search(...)` always returns None without special-casing.
             # Instance names are not case-sensitive, so instances should not have names that differ only in case.
             # See: https://learn.microsoft.com/en-us/windows/win32/perfctrs/about-performance-counters
-            self.exclude_pattern = re.compile('|'.join(final_exclude_patterns), re.IGNORECASE)
+            self.exclude_pattern = re.compile('|'.join(final_exclude_patterns) or r'(?!)', re.IGNORECASE)
 
         # List of wildcards or instance name directly to filter multi-instance counters by PDH layer itself.
         # Thus it is faster and and less resource intensive than regex-based include filtering.
diff --git a/datadog_checks_base/tests/base/checks/windows/perf_counters/test_filter.py b/datadog_checks_base/tests/base/checks/windows/perf_counters/test_filter.py
index bd6d2058f53cb..80124360db242 100644
--- a/datadog_checks_base/tests/base/checks/windows/perf_counters/test_filter.py
+++ b/datadog_checks_base/tests/base/checks/windows/perf_counters/test_filter.py
@@ -75,3 +75,62 @@ def test_include_case_insensitive(aggregator, dd_run_check, mock_performance_obj
     aggregator.assert_metric_has_tag('test.foo.bar', 'instance:Barbat', count=0)
 
     aggregator.assert_all_metrics_covered()
+
+
+def test_include_total(aggregator, dd_run_check, mock_performance_objects):
+    mock_performance_objects({'Foo': (['_Total', 'baz'], {'Bar': [1, 2]})})
+    check = get_check(
+        {'metrics': {'Foo': {'name': 'foo', 'include_total': True, 'counters': [{'Bar': 'bar'}]}}}
+    )
+    dd_run_check(check)
+
+    tags = ['instance:_Total']
+    tags.extend(GLOBAL_TAGS)
+    aggregator.assert_metric('test.foo.bar', 1, tags=tags)
+
+    tags = ['instance:baz']
+    tags.extend(GLOBAL_TAGS)
+    aggregator.assert_metric('test.foo.bar', 2, tags=tags)
+
+    aggregator.assert_all_metrics_covered()
+
+
+def test_include_total_with_lowercase_instance(aggregator, dd_run_check, mock_performance_objects):
+    mock_performance_objects({'Foo': (['_total', 'baz'], {'Bar': [1, 2]})})
+    check = get_check(
+        {'metrics': {'Foo': {'name': 'foo', 'include_total': True, 'counters': [{'Bar': 'bar'}]}}}
+    )
+    dd_run_check(check)
+
+    tags = ['instance:_total']
+    tags.extend(GLOBAL_TAGS)
+    aggregator.assert_metric('test.foo.bar', 1, tags=tags)
+
+    aggregator.assert_metric_has_tag('test.foo.bar', 'instance:baz', count=1)
+
+    aggregator.assert_all_metrics_covered()
+
+
+def test_include_total_respects_user_exclude(aggregator, dd_run_check, mock_performance_objects):
+    mock_performance_objects({'Foo': (['_Total', 'baz'], {'Bar': [1, 2]})})
+    check = get_check(
+        {
+            'metrics': {
+                'Foo': {
+                    'name': 'foo',
+                    'include_total': True,
+                    'exclude': ['baz'],
+                    'counters': [{'Bar': 'bar'}],
+                }
+            }
+        }
+    )
+    dd_run_check(check)
+
+    tags = ['instance:_Total']
+    tags.extend(GLOBAL_TAGS)
+    aggregator.assert_metric('test.foo.bar', 1, tags=tags)
+
+    aggregator.assert_metric_has_tag('test.foo.bar', 'instance:baz', count=0)
+
+    aggregator.assert_all_metrics_covered()
diff --git a/datadog_checks_dev/datadog_checks/dev/tooling/templates/configuration/common/perf_counters.yaml b/datadog_checks_dev/datadog_checks/dev/tooling/templates/configuration/common/perf_counters.yaml
index d5b5a59f6e617..907d772c65e18 100644
--- a/datadog_checks_dev/datadog_checks/dev/tooling/templates/configuration/common/perf_counters.yaml
+++ b/datadog_checks_dev/datadog_checks/dev/tooling/templates/configuration/common/perf_counters.yaml
@@ -26,7 +26,15 @@
       include: This is the list of regular expressions used to select which instances to monitor.
                If not set, all instances are monitored.
       exclude: This is the list of regular expressions used to select which instances to ignore.
-               If not set, no instances are ignored. Note: `_Total` instances are always ignored.
+               If not set, no instances are ignored. Note: `_Total` instances are ignored by default;
+               set `include_total` to `true` to collect them.
+      include_total: Whether to collect the `_Total` aggregate instance for this performance object.
+                     Defaults to `false`. Most performance objects report `_Total` as the sum of the
+                     individual instances, in which case it is preferable to compute the total in
+                     Datadog. However, some perf objects (e.g. `MSExchangeTransport Queues`) report
+                     data on `_Total` that is not derivable from the visible instances, and in that
+                     case opting in restores the missing data without forcing the collection of every
+                     individual instance.
       include_fast: This is the list of wildcards or exact instance names used to select which
                     instances to monitor. It is faster than the regular expression `include` filter
                     because it relies on the Windows PDH built-in wildcard filtering.
@@ -95,6 +103,8 @@
         type: array
         items:
           type: string
+      - name: include_total
+        type: boolean
       - name: instance_counts
         type: object
         properties: