diff --git a/SingleAppInstance.Test/SingleAppInstanceTests.cs b/SingleAppInstance.Test/SingleAppInstanceTests.cs
index 871d8b9..2ee28f6 100644
--- a/SingleAppInstance.Test/SingleAppInstanceTests.cs
+++ b/SingleAppInstance.Test/SingleAppInstanceTests.cs
@@ -291,6 +291,101 @@ public void IsAlreadyRunning_WithRunningProcessButDifferentName_ShouldReturnFals
 		}
 	}
 
+	[TestMethod]
+	public void IsAlreadyRunning_WithMatchingProcessButDifferentStartTime_ShouldReturnFalse()
+	{
+		// Arrange - the PID, name and main module all describe a live process, but the start time
+		// does not, which is what a stale PID file looks like once the operating system recycles the
+		// PID onto another process run by the same host, such as another `dotnet` process
+		string pidFilePath = SingleAppInstance.PidFilePath;
+		using HelperProcess helper = HelperProcess.Start("StartTimeHelper");
+
+		ProcessInfo processInfo = DescribeProcess(helper.Process);
+		processInfo.StartTime = processInfo.StartTime.AddHours(-1);
+		File.WriteAllText(pidFilePath, JsonSerializer.Serialize(processInfo));
+
+		// Act
+		bool result = SingleAppInstance.IsAlreadyRunning();
+
+		// Assert
+		Assert.IsFalse(result, "Should return false when the running process started at a different time than the stored one");
+	}
+
+	[TestMethod]
+	public void IsAlreadyRunning_WithMatchingProcessAndStartTime_ShouldReturnTrue()
+	{
+		// Arrange - every stored field describes the live process, so it is another instance
+		string pidFilePath = SingleAppInstance.PidFilePath;
+		using HelperProcess helper = HelperProcess.Start("StartTimeHelper");
+
+		File.WriteAllText(pidFilePath, JsonSerializer.Serialize(DescribeProcess(helper.Process)));
+
+		// Act
+		bool result = SingleAppInstance.IsAlreadyRunning();
+
+		// Assert
+		Assert.IsTrue(result, "Should return true when the stored process information matches a running process");
+	}
+
+	[TestMethod]
+	public void IsAlreadyRunning_WithMatchingProcessAndNoStoredStartTime_ShouldReturnTrue()
+	{
+		// Arrange - a PID file written before the start time was recorded deserializes it as default
+		string pidFilePath = SingleAppInstance.PidFilePath;
+		using HelperProcess helper = HelperProcess.Start("StartTimeHelper");
+
+		ProcessInfo processInfo = DescribeProcess(helper.Process);
+		processInfo.StartTime = default;
+		File.WriteAllText(pidFilePath, JsonSerializer.Serialize(processInfo));
+
+		// Act
+		bool result = SingleAppInstance.IsAlreadyRunning();
+
+		// Assert
+		Assert.IsTrue(result, "Should fall back to the name and module check when no start time was stored");
+	}
+
+	[TestMethod]
+	public void HasStoredStartTime_WithinTolerance_ShouldReturnTrue()
+	{
+		DateTime stored = new(2026, 1, 1, 12, 0, 0, DateTimeKind.Utc);
+
+		Assert.IsTrue(SingleAppInstance.HasStoredStartTime(() => stored.AddMilliseconds(900), stored));
+		Assert.IsTrue(SingleAppInstance.HasStoredStartTime(() => stored.AddMilliseconds(-900), stored));
+	}
+
+	[TestMethod]
+	public void HasStoredStartTime_BeyondTolerance_ShouldReturnFalse()
+	{
+		DateTime stored = new(2026, 1, 1, 12, 0, 0, DateTimeKind.Utc);
+
+		Assert.IsFalse(SingleAppInstance.HasStoredStartTime(() => stored.AddSeconds(2), stored));
+		Assert.IsFalse(SingleAppInstance.HasStoredStartTime(() => stored.AddSeconds(-2), stored));
+	}
+
+	[TestMethod]
+	public void HasStoredStartTime_ComparesLocalAndUniversalTimesAsTheSameInstant()
+	{
+		DateTime stored = new(2026, 1, 1, 12, 0, 0, DateTimeKind.Utc);
+
+		Assert.IsTrue(SingleAppInstance.HasStoredStartTime(stored.ToLocalTime, stored));
+	}
+
+	[TestMethod]
+	public void HasStoredStartTime_WithNoStoredStartTime_ShouldNotReadTheRunningStartTime()
+	{
+		Assert.IsTrue(SingleAppInstance.HasStoredStartTime(() => throw new AssertFailedException("The running start time should not be read"), default));
+	}
+
+	[TestMethod]
+	public void HasStoredStartTime_WhenRunningStartTimeIsUnavailable_ShouldReturnTrue()
+	{
+		DateTime stored = new(2026, 1, 1, 12, 0, 0, DateTimeKind.Utc);
+
+		Assert.IsTrue(SingleAppInstance.HasStoredStartTime(() => throw new InvalidOperationException(), stored));
+		Assert.IsTrue(SingleAppInstance.HasStoredStartTime(() => throw new Win32Exception(), stored));
+	}
+
 	[TestMethod]
 	public void IsAlreadyRunning_WithHighNonExistentPid_ShouldReturnFalse()
 	{
@@ -491,6 +586,17 @@ public void IsAlreadyRunning_WithJsonArrayInPidFile_ShouldReturnFalse()
 		Assert.IsFalse(result);
 	}
 
+	/// <summary>
+	/// Describes a running process the way <see cref="SingleAppInstance.WritePidFile"/> records one.
+	/// </summary>
+	private static ProcessInfo DescribeProcess(Process process) => new()
+	{
+		ProcessId = process.Id,
+		ProcessName = process.ProcessName,
+		StartTime = process.StartTime,
+		MainModuleFileName = process.MainModule?.FileName,
+	};
+
 	/// <summary>
 	/// Finds a running process that is neither the current process nor shares its process name.
 	/// </summary>
@@ -601,7 +707,38 @@ public static HelperProcess Start(string processName)
 			Process? process = Process.Start(startInfo);
 			Assert.IsNotNull(process, "Should be able to start a helper process");
 
-			return new HelperProcess(process, temporaryDirectory);
+			HelperProcess helper = new(process, temporaryDirectory);
+			helper.WaitForMainModule();
+			return helper;
+		}
+
+		/// <summary>
+		/// Waits until the helper's main module can be read, since Windows reports none until the
+		/// loader has finished starting the process, and a test that records it too early would
+		/// describe a different process from the one IsAlreadyRunning later inspects.
+		/// </summary>
+		private void WaitForMainModule()
+		{
+			Stopwatch stopwatch = Stopwatch.StartNew();
+			while (stopwatch.Elapsed < TimeSpan.FromSeconds(10))
+			{
+				Process.Refresh();
+				try
+				{
+					if (Process.MainModule?.FileName is not null)
+					{
+						return;
+					}
+				}
+				catch (Win32Exception)
+				{
+					// The module list is not readable yet
+				}
+
+				Thread.Sleep(50);
+			}
+
+			Assert.Inconclusive("The helper process's main module never became readable");
 		}
 
 		public void Dispose()
diff --git a/SingleAppInstance/SingleAppInstance.cs b/SingleAppInstance/SingleAppInstance.cs
index f7803f2..1c4f698 100644
--- a/SingleAppInstance/SingleAppInstance.cs
+++ b/SingleAppInstance/SingleAppInstance.cs
@@ -206,7 +206,8 @@ private static bool IsStoredProcessRunning(ProcessInfo storedProcess)
 			return !runningProcess.HasExited &&
 				string.Equals(runningProcess.ProcessName, storedProcess.ProcessName, StringComparison.Ordinal) &&
 				runningProcess.MainModule != null &&
-				string.Equals(runningProcess.MainModule.FileName, storedProcess.MainModuleFileName, StringComparison.OrdinalIgnoreCase);
+				string.Equals(runningProcess.MainModule.FileName, storedProcess.MainModuleFileName, StringComparison.OrdinalIgnoreCase) &&
+				HasStoredStartTime(runningProcess, storedProcess);
 		}
 		catch (ArgumentException)
 		{
@@ -237,7 +238,7 @@ private static bool IsStoredProcessRunningByName(ProcessInfo storedProcess)
 			using Process process = Process.GetProcessById(storedProcess.ProcessId);
 
 			return !process.HasExited &&
-				string.Equals(process.ProcessName, storedProcess.ProcessName, StringComparison.Ordinal);
+				string.Equals(process.ProcessName, storedProcess.ProcessName, StringComparison.Ordinal) && HasStoredStartTime(process, storedProcess);
 		}
 		catch (ArgumentException)
 		{
@@ -256,6 +257,52 @@ private static bool IsStoredProcessRunningByName(ProcessInfo storedProcess)
 		}
 	}
 
+	/// <summary>
+	/// How far apart the stored and observed start times of one process may be, allowing for the
+	/// precision lost in the JSON round trip and for platforms that derive start time from clock ticks.
+	/// </summary>
+	private static readonly TimeSpan StartTimeTolerance = TimeSpan.FromSeconds(1);
+
+	/// <summary>
+	/// Checks whether a running process started when the PID file says the stored process did.
+	/// </summary>
+	/// <param name="runningProcess">The running process that currently holds the stored PID.</param>
+	/// <param name="storedProcess">The process information read from the PID file.</param>
+	/// <returns><c>true</c> if the start times match or cannot be compared; otherwise, <c>false</c>.</returns>
+	/// <remarks>
+	/// An application run through the shared <c>dotnet</c> host has the same process name and main module
+	/// as every other process that host runs, so a stale PID recycled onto any of them would otherwise pass
+	/// as another instance. The start time tells them apart. PID files written before the start time was
+	/// recorded, and processes whose start time cannot be read, keep the name and module check alone.
+	/// </remarks>
+	private static bool HasStoredStartTime(Process runningProcess, ProcessInfo storedProcess) =>
+		HasStoredStartTime(() => runningProcess.StartTime, storedProcess.StartTime);
+
+	/// <summary>
+	/// Checks whether a running process's start time matches the stored one.
+	/// </summary>
+	/// <param name="readRunningStartTime">Reads the running process's start time.</param>
+	/// <param name="storedStartTime">The start time read from the PID file.</param>
+	/// <returns><c>true</c> if the start times match or cannot be compared; otherwise, <c>false</c>.</returns>
+	internal static bool HasStoredStartTime(Func<DateTime> readRunningStartTime, DateTime storedStartTime)
+	{
+		if (storedStartTime == default)
+		{
+			return true;
+		}
+
+		try
+		{
+			TimeSpan difference = readRunningStartTime().ToUniversalTime() - storedStartTime.ToUniversalTime();
+			return difference.Duration() <= StartTimeTolerance;
+		}
+		catch (Exception ex) when (ex is InvalidOperationException or System.ComponentModel.Win32Exception)
+		{
+			// The start time is unavailable or access to it is denied
+			return true;
+		}
+	}
+
 	/// <summary>
 	/// Checks if the PID read from a legacy PID file belongs to another running instance of this application.
 	/// </summary>