diff --git a/CHANGELOG.md b/CHANGELOG.md
index 3a1d2bf..c68f262 100644
--- a/CHANGELOG.md
+++ b/CHANGELOG.md
@@ -1,6 +1,8 @@
 # Changes
 
 * 2.3.next in progress
+  * Fix [#438](https://github.com/seancorfield/honeysql/issues/438) by
+  supporting options on `TRUNCATE`.
   * Address [#435](https://github.com/seancorfield/honeysql/issues/435) by showing `CREATE TEMP TABLE` etc.
   * Fix [#431](https://github.com/seancorfield/honeysql/issues/431).
   * Address [#430](https://github.com/seancorfield/honeysql/issues/430) by treating `:'` as introducing a name that should be treating literally and not formatted as a SQL entity (which respects quoting, dot-splitting, etc); this effectively expands the "escape hatch" introduced via [#352](https://github.com/seancorfield/honeysql/issues/352) in 2.2.868. _Note that the function context behavior formats as a SQL entity, rather than the usual SQL "keyword", whereas this new context is a literal transcription rather than as a SQL entity!_
diff --git a/doc/clause-reference.md b/doc/clause-reference.md
index ef5959d..cc14855 100644
--- a/doc/clause-reference.md
+++ b/doc/clause-reference.md
@@ -321,7 +321,7 @@ order they would appear in a valid SQL statement).
 
 These provide CTE support for SQL Server. The argument to
 `:with` (or `:with-recursive`) is a sequences of pairs, each of
-a result set name (or description) and either of; a basic SQL 
+a result set name (or description) and either of; a basic SQL
 statement, a string, a keyword or a symbol.
 The result set can either be a SQL entity (a simple name)
 or a pair of a SQL entity and a set of column names.
@@ -336,7 +336,7 @@ user=> (sql/format '{with ((stuff {select (:*) from (foo)}),
 ```
 
 When the expression is a basic SQL statement in any of the pairs,
-the resulting syntax of the pair is `with ident AS expr` as shown above. 
+the resulting syntax of the pair is `with ident AS expr` as shown above.
 However, when the expression is a string, a keyword or a symbol, the resulting
 syntax of the pair is of the form `with expr AS ident` like this:
 
@@ -348,7 +348,7 @@ user=> (sql/format '{with ((ts_upper_bound "2019-08-01 15:23:00"))
 ["WITH ? AS ts_upper_bound SELECT * FROM hits WHERE EventDate = ts_upper_bound" "2019-08-01 15:23:00"]
 ```
 
-The syntax only varies for each pair and so you can use both SQL statements 
+The syntax only varies for each pair and so you can use both SQL statements
 and keywords/strings/symbols in the same WITH clause like this:
 
 ```clojure
@@ -590,11 +590,14 @@ user=> (sql/format {:delete [:order :item]
 
 ## truncate
 
-`:truncate` accepts a simple SQL entity (table name):
+`:truncate` accepts a simple SQL entity (table name)
+or a table name followed by various options:
 
 ```clojure
 user=> (sql/format '{truncate transport})
 ["TRUNCATE transport"]
+user=> (sql/format '{truncate (transport restart identity)})
+["TRUNCATE transport RESTART IDENTITY"]
 ```
 
 ## columns
diff --git a/src/honey/sql.cljc b/src/honey/sql.cljc
index 8680993..27f798d 100644
--- a/src/honey/sql.cljc
+++ b/src/honey/sql.cljc
@@ -894,14 +894,14 @@
           :else
           (sql-kw opt))))
 
-(defn- destructure-create-item [table context]
+(defn- destructure-ddl-item [table context]
   (let [params
         (if (sequential? table)
           table
           [table])
         tab? #(or (ident? %) (string? %))
         coll (take-while tab? params)
-        opts (drop-while tab? params)
+        opts (filter some? (drop-while tab? params))
         ine  (last coll)
         [prequel table ine]
         (if (= :if-not-exists (sym->kw ine))
@@ -910,11 +910,26 @@
     (into [(str/join " " (map sql-kw prequel))
            (format-entity table)
            (when ine (sql-kw ine))]
-          (format-ddl-options opts context))))
+          (when opts
+            (format-ddl-options opts context)))))
+
+(defn- format-truncate [k xs]
+  (let [[table & options] (if (sequential? xs) xs [xs])
+        [pre table ine options] (destructure-ddl-item [table options] "truncate")]
+    (when (seq pre) (throw (ex-info "TRUNCATE syntax error" {:unexpected pre})))
+    (when (seq ine) (throw (ex-info "TRUNCATE syntax error" {:unexpected ine})))
+    [(str/join " " (cond-> [(sql-kw k) table]
+                     (seq options)
+                     (conj options)))]))
+
+(comment
+  (destructure-ddl-item [:foo [:abc [:continue :wibble] :identity]] "test")
+  (destructure-ddl-item [:foo] "test")
+  (format-truncate :truncate [:foo]))
 
 (defn- format-create [q k item as]
   (let [[pre entity ine & more]
-        (destructure-create-item item (str (sql-kw q) " options"))]
+        (destructure-ddl-item item (str (sql-kw q) " options"))]
     [(str/join " " (remove nil?
                            (-> [(sql-kw q)
                                 (when (and (= :create q) (seq pre)) pre)
@@ -1098,7 +1113,7 @@
          :update          (check-where #'format-selector)
          :delete          (check-where #'format-selects)
          :delete-from     (check-where #'format-selector)
-         :truncate        #'format-selector
+         :truncate        #'format-truncate
          :columns         #'format-columns
          :set             #'format-set-exprs
          :from            #'format-selects
diff --git a/test/honey/sql_test.cljc b/test/honey/sql_test.cljc
index 6f53613..952f359 100644
--- a/test/honey/sql_test.cljc
+++ b/test/honey/sql_test.cljc
@@ -519,6 +519,9 @@
 (deftest truncate-test
   (is (= ["TRUNCATE `foo`"]
          (-> {:truncate :foo}
+             (format {:dialect :mysql}))))
+  (is (= ["TRUNCATE `foo` CONTINUE IDENTITY"]
+         (-> {:truncate [:foo :continue :identity]}
              (format {:dialect :mysql})))))
 
 (deftest inlined-values-are-stringified-correctly