diff --git a/README.md b/README.md
index c6f4ef4c..c45138a3 100644
--- a/README.md
+++ b/README.md
@@ -191,6 +191,9 @@ reasonable defaults that can be accessed in a few ways:
 * When invoking Node: `node -r sucrase/register main.ts`
 * As a separate binary: `sucrase-node main.ts`
 
+Options can be passed to the require hook via a `SUCRASE_OPTIONS` environment
+variable holding a JSON string of options.
+
 ### Compiling a project to JS
 
 For simple use cases, Sucrase comes with a `sucrase` CLI that mirrors your
diff --git a/integration-test/integration-tests.ts b/integration-test/integration-tests.ts
index 49685b8e..fbc893a5 100644
--- a/integration-test/integration-tests.ts
+++ b/integration-test/integration-tests.ts
@@ -2,7 +2,7 @@ import assert from "assert";
 import {exec} from "child_process";
 import {readdirSync, statSync} from "fs";
 import {rm, writeFile} from "fs/promises";
-import {join, dirname, resolve} from "path";
+import {join, dirname, resolve, basename} from "path";
 import {promisify} from "util";
 
 import {
@@ -44,8 +44,15 @@ describe("integration tests", () => {
    * in such a way that the execution throws an exception if the test fails.
    */
   for (const testFile of discoverTests("test-cases/register-cases", "main")) {
-    it(testFile, async () => {
-      await execPromise(`node -r ${__dirname}/../register ${testFile}`);
+    const testDir = dirname(testFile);
+    it(testDir, async () => {
+      process.chdir(testDir);
+      const testConfig = await readJSONFileContentsIfExists("./test.json");
+      let envPrefix = "";
+      if (testConfig?.sucraseOptions) {
+        envPrefix = `SUCRASE_OPTIONS='${JSON.stringify(testConfig.sucraseOptions)}' `;
+      }
+      await execPromise(`${envPrefix}node -r ${__dirname}/../register ${basename(testFile)}`);
     });
   }
 
diff --git a/integration-test/test-cases/register-cases/respects-preserve-dynamic-import-option/esm-file.mjs b/integration-test/test-cases/register-cases/respects-preserve-dynamic-import-option/esm-file.mjs
new file mode 100644
index 00000000..0146d2af
--- /dev/null
+++ b/integration-test/test-cases/register-cases/respects-preserve-dynamic-import-option/esm-file.mjs
@@ -0,0 +1 @@
+export const foo = 3;
diff --git a/integration-test/test-cases/register-cases/respects-preserve-dynamic-import-option/main.js b/integration-test/test-cases/register-cases/respects-preserve-dynamic-import-option/main.js
new file mode 100644
index 00000000..1129e539
--- /dev/null
+++ b/integration-test/test-cases/register-cases/respects-preserve-dynamic-import-option/main.js
@@ -0,0 +1,7 @@
+async function main() {
+  const plainESMFile = await import("./esm-file.mjs");
+  if (plainESMFile.foo !== 3) {
+    throw new Error();
+  }
+}
+main();
diff --git a/integration-test/test-cases/register-cases/respects-preserve-dynamic-import-option/test.json b/integration-test/test-cases/register-cases/respects-preserve-dynamic-import-option/test.json
new file mode 100644
index 00000000..f851d0fe
--- /dev/null
+++ b/integration-test/test-cases/register-cases/respects-preserve-dynamic-import-option/test.json
@@ -0,0 +1,5 @@
+{
+  "sucraseOptions": {
+    "preserveDynamicImport": true
+  }
+}
diff --git a/src/register.ts b/src/register.ts
index bdb2ffd5..ee37e098 100644
--- a/src/register.ts
+++ b/src/register.ts
@@ -11,13 +11,18 @@ export type RevertFunction = () => void;
 
 export function addHook(
   extension: string,
-  options: Options,
+  sucraseOptions: Options,
   hookOptions?: HookOptions,
 ): RevertFunction {
+  let mergedSucraseOptions = sucraseOptions;
+  const sucraseOptionsEnvJSON = process.env.SUCRASE_OPTIONS;
+  if (sucraseOptionsEnvJSON) {
+    mergedSucraseOptions = {...mergedSucraseOptions, ...JSON.parse(sucraseOptionsEnvJSON)};
+  }
   return pirates.addHook(
     (code: string, filePath: string): string => {
       const {code: transformedCode, sourceMap} = transform(code, {
-        ...options,
+        ...mergedSucraseOptions,
         sourceMapOptions: {compiledFilename: filePath},
         filePath,
       });