diff --git a/CHANGELOG.md b/CHANGELOG.md
index c1af9f9..3dabf83 100644
--- a/CHANGELOG.md
+++ b/CHANGELOG.md
@@ -2,6 +2,9 @@
 
 Only accretive/fixative changes will be made from now on.
 
+* 1.3.next in progress
+  * Address [#256](https://github.com/seancorfield/next-jdbc/issues/256) by adding `with-transaction+options`. Documentation TBD.
+
 * 1.3.883 -- 2023-06-25
   * Address [#254](https://github.com/seancorfield/next-jdbc/issues/254) by adding `next.jdbc/active-tx?` and adding more explanation to [**Transactions**](https://cljdoc.org/d/com.github.seancorfield/next.jdbc/CURRENT/doc/getting-started/transactions) about the conventions behind transactions and the limitations of thread-local tracking of active transactions in `next.jdbc`.
   * Address [#251](https://github.com/seancorfield/next-jdbc/issues/251) by updating `next.jdbc/with-logging` docstring.
diff --git a/resources/clj-kondo.exports/com.github.seancorfield/next.jdbc/config.edn b/resources/clj-kondo.exports/com.github.seancorfield/next.jdbc/config.edn
index 57911b6..cfe5a72 100644
--- a/resources/clj-kondo.exports/com.github.seancorfield/next.jdbc/config.edn
+++ b/resources/clj-kondo.exports/com.github.seancorfield/next.jdbc/config.edn
@@ -1,5 +1,7 @@
 {:hooks
  {:analyze-call
   {next.jdbc/with-transaction
-   hooks.com.github.seancorfield.next-jdbc/with-transaction}}
- :lint-as {next.jdbc/on-connection clojure.core/with-open}}
\ No newline at end of file
+   hooks.com.github.seancorfield.next-jdbc/with-transaction
+   next.jdbc/with-transaction+options
+   hooks.com.github.seancorfield.next-jdbc/with-transaction+options}}
+ :lint-as {next.jdbc/on-connection clojure.core/with-open}}
diff --git a/resources/clj-kondo.exports/com.github.seancorfield/next.jdbc/hooks/com/github/seancorfield/next_jdbc.clj_kondo b/resources/clj-kondo.exports/com.github.seancorfield/next.jdbc/hooks/com/github/seancorfield/next_jdbc.clj_kondo
index daedc45..9fc398d 100644
--- a/resources/clj-kondo.exports/com.github.seancorfield/next.jdbc/hooks/com/github/seancorfield/next_jdbc.clj_kondo
+++ b/resources/clj-kondo.exports/com.github.seancorfield/next.jdbc/hooks/com/github/seancorfield/next_jdbc.clj_kondo
@@ -16,3 +16,19 @@
                      opts
                      body))]
       {:node new-node})))
+
+(defn with-transaction+options
+  "Expands (with-transaction+options [tx expr opts] body)
+  to (let [tx expr] opts body) per clj-kondo examples."
+  [{:keys [:node]}]
+  (let [[binding-vec & body] (rest (:children node))
+        [sym val opts] (:children binding-vec)]
+    (when-not (and sym val)
+      (throw (ex-info "No sym and val provided" {})))
+    (let [new-node (api/list-node
+                    (list*
+                     (api/token-node 'let)
+                     (api/vector-node [sym val])
+                     opts
+                     body))]
+      {:node new-node})))
diff --git a/src/next/jdbc.clj b/src/next/jdbc.clj
index 4b8d49d..8ea448a 100644
--- a/src/next/jdbc.clj
+++ b/src/next/jdbc.clj
@@ -389,6 +389,9 @@
   Like `with-open`, if `with-transaction` creates a new `Connection` object,
   it will automatically close it for you.
 
+  If you are working with default options via `with-options`, you might want
+  to use `with-transaction+options` instead.
+
   The options map supports:
   * `:isolation` -- `:none`, `:read-committed`, `:read-uncommitted`,
       `:repeatable-read`, `:serializable`,
@@ -419,9 +422,45 @@
   return plain Java objects, so if you call any of those on this wrapped
   object, you'll need to re-wrap the Java object `with-options` again. See
   the Datasources, Connections & Transactions section of Getting Started for
-  more details, and some examples of use with these functions."
+  more details, and some examples of use with these functions.
+
+  `with-transaction+options` exists to automatically rewrap a `Connection`
+  with the options from a `with-options` wrapper."
   [connectable opts]
-  (opts/->DefaultOptions connectable opts))
+  (let [c (:connectable connectable)
+        o (:options connectable)]
+    (if (and c o)
+      (opts/->DefaultOptions c (merge o opts))
+      (opts/->DefaultOptions connectable opts))))
+
+(defmacro with-transaction+options
+  "Given a transactable object, assumed to be wrapped with options, gets a
+  connection, rewraps it with those options, and binds it to `sym`, then
+  executes the `body` in that context, committing any changes if the body
+  completes successfully, otherwise rolling back any changes made.
+
+  Like `with-open`, if `with-transaction+options` creates a new `Connection`
+  object, it will automatically close it for you.
+
+  Note: the bound `sym` will be a **wrapped** connectable and not a plain
+  Java object, so you cannot call JDBC methods directly on it like you can
+  with `with-transaction`.
+
+  The options map supports:
+  * `:isolation` -- `:none`, `:read-committed`, `:read-uncommitted`,
+      `:repeatable-read`, `:serializable`,
+  * `:read-only` -- `true` / `false` (`true` will make the `Connection` readonly),
+  * `:rollback-only` -- `true` / `false` (`true` will make the transaction
+      rollback, even if it would otherwise succeed)."
+  [[sym transactable opts] & body]
+  (let [con (vary-meta sym assoc :tag 'java.sql.Connection)]
+   `(let [tx# ~transactable]
+      (transact tx#
+               (^{:once true} fn*
+                [con#]
+                (let [~con (with-options con# (:options tx# {}))]
+                  ~@body))
+               ~(or opts {})))))
 
 (defn with-logging
   "Given a connectable/transactable object and a sql/params logging
diff --git a/test/next/jdbc_test.clj b/test/next/jdbc_test.clj
index 721dcfe..36d2480 100644
--- a/test/next/jdbc_test.clj
+++ b/test/next/jdbc_test.clj
@@ -65,6 +65,18 @@
                      ds-opts
                      ["select appearance as looks_like from fruit where id = ?" 1]
                      jdbc/snake-kebab-opts))))
+      (let [ds' (jdbc/with-options ds-opts jdbc/snake-kebab-opts)]
+        (is (= "red" (:fruit/looks-like
+                      (jdbc/execute-one!
+                       ds'
+                       ["select appearance as looks_like from fruit where id = ?" 1])))))
+      (jdbc/with-transaction+options [ds' (jdbc/with-options ds-opts jdbc/snake-kebab-opts)]
+        (is (= (merge (default-options) jdbc/snake-kebab-opts)
+               (:options ds')))
+        (is (= "red" (:fruit/looks-like
+                      (jdbc/execute-one!
+                       ds'
+                       ["select appearance as looks_like from fruit where id = ?" 1])))))
       (is (= "red" (:looks-like
                     (jdbc/execute-one!
                      ds-opts