diff --git a/pages/table-root/header-truncation.page.tsx b/pages/table-root/header-truncation.page.tsx
new file mode 100644
index 00000000000..ad23e8f4d27
--- /dev/null
+++ b/pages/table-root/header-truncation.page.tsx
@@ -0,0 +1,48 @@
+// Copyright Amazon.com, Inc. or its affiliates. All Rights Reserved.
+// SPDX-License-Identifier: Apache-2.0
+import React from 'react';
+
+import TableBody from '~components/table-body';
+import TableBodyCell from '~components/table-body-cell';
+import TableHead from '~components/table-head';
+import TableHeaderCell from '~components/table-header-cell';
+import TableRoot, { TableRootProps } from '~components/table-root';
+import TableRow from '~components/table-row';
+
+import { SimplePage } from '../app/templates';
+
+import styles from './styles.scss';
+
+// Each column is narrower than its header label, so every header truncates.
+const NARROW_COLUMNS: ReadonlyArray<TableRootProps.ColumnDefinition> = [{ size: 120 }, { size: 100 }, { size: 100 }];
+
+export default function TableHeaderTruncationPage() {
+  return (
+    <SimplePage title="Table atomics — header truncation">
+      <TableRoot
+        columnLayout={{ type: 'grid', columns: NARROW_COLUMNS }}
+        ariaLabel="Narrow columns"
+        data-testid="narrow-table"
+      >
+        <TableHead>
+          <TableRow>
+            <TableHeaderCell>
+              <button type="button" className={styles['sort-button']} data-testid="first-header-button">
+                @timestampMilliseconds
+              </button>
+            </TableHeaderCell>
+            <TableHeaderCell>@billedDuration</TableHeaderCell>
+            <TableHeaderCell>@memoryAllocated</TableHeaderCell>
+          </TableRow>
+        </TableHead>
+        <TableBody>
+          <TableRow>
+            <TableBodyCell>1,700,000</TableBodyCell>
+            <TableBodyCell>120</TableBodyCell>
+            <TableBodyCell>512</TableBodyCell>
+          </TableRow>
+        </TableBody>
+      </TableRoot>
+    </SimplePage>
+  );
+}
diff --git a/src/table-header-cell/__integ__/truncation.test.ts b/src/table-header-cell/__integ__/truncation.test.ts
new file mode 100644
index 00000000000..18a922241a2
--- /dev/null
+++ b/src/table-header-cell/__integ__/truncation.test.ts
@@ -0,0 +1,62 @@
+// Copyright Amazon.com, Inc. or its affiliates. All Rights Reserved.
+// SPDX-License-Identifier: Apache-2.0
+import { BasePageObject } from '@cloudscape-design/browser-test-tools/page-objects';
+import useBrowser from '@cloudscape-design/browser-test-tools/use-browser';
+
+import bodyCellStyles from '../../../lib/components/table/body-cell/styles.selectors.js';
+import styles from '../../../lib/components/table-header-cell/styles.selectors.js';
+
+const pageUrl = '#/light/table-root/header-truncation';
+const headerContent = `[data-testid="narrow-table"] .${styles['header-cell-content']}`;
+const firstHeaderButton = '[data-testid="first-header-button"]';
+
+test(
+  'truncates header text that is wider than its column with an ellipsis',
+  useBrowser(async browser => {
+    await browser.url(pageUrl);
+    const page = new BasePageObject(browser);
+    await page.waitForVisible(headerContent);
+
+    const contents = await browser.execute((selector: string) => {
+      return Array.from(document.querySelectorAll<HTMLElement>(selector)).map(element => ({
+        overflowsContent: element.scrollWidth > element.clientWidth,
+        textOverflow: getComputedStyle(element).textOverflow,
+        rightOverhang: element.getBoundingClientRect().right - element.parentElement!.getBoundingClientRect().right,
+      }));
+    }, headerContent);
+
+    expect(contents).toHaveLength(3);
+    for (const content of contents) {
+      expect(content.overflowsContent).toBe(true);
+      expect(content.textOverflow).toBe('ellipsis');
+      expect(content.rightOverhang).toBeLessThanOrEqual(0);
+    }
+  })
+);
+
+test(
+  'leaves room inside the clip for a focus ring on the first column, without moving its text',
+  useBrowser(async browser => {
+    await browser.url(pageUrl);
+    const page = new BasePageObject(browser);
+    await page.waitForVisible(firstHeaderButton);
+
+    const { buttonLeft, clipLeft, bodyTextLeft } = await browser.execute(
+      (buttonSelector: string, bodyContentClass: string) => {
+        const button = document.querySelector<HTMLElement>(buttonSelector)!;
+        const bodyContent = document.querySelector<HTMLElement>(`.${bodyContentClass}`)!;
+        return {
+          buttonLeft: button.getBoundingClientRect().left,
+          clipLeft: button.parentElement!.getBoundingClientRect().left,
+          bodyTextLeft:
+            bodyContent.getBoundingClientRect().left + parseFloat(getComputedStyle(bodyContent).paddingInlineStart),
+        };
+      },
+      firstHeaderButton,
+      bodyCellStyles['body-cell-content']
+    );
+
+    expect(buttonLeft - clipLeft).toBeGreaterThanOrEqual(4);
+    expect(buttonLeft).toBe(bodyTextLeft);
+  })
+);
diff --git a/src/table-header-cell/styles.scss b/src/table-header-cell/styles.scss
index dfae49be290..6c4c4b75483 100644
--- a/src/table-header-cell/styles.scss
+++ b/src/table-header-cell/styles.scss
@@ -43,9 +43,18 @@
   padding-inline: 0;
 }
 
+.header-cell:not(.disable-paddings) > .header-cell-content {
+  white-space: nowrap;
+  overflow: hidden;
+  text-overflow: ellipsis;
+}
+
 // VR-gated: the substrate is shared with the existing Table, which still supports non-VR mode.
-.header-cell.is-visual-refresh:first-child > .header-cell-content {
-  padding-inline-start: 0;
+// The text sits flush with the cell's start edge, but the padding/margin pair keeps room inside the
+// truncation clip so a focus ring on the first control isn't cut off.
+.header-cell.is-visual-refresh:first-child:not(.disable-paddings) > .header-cell-content {
+  padding-inline-start: awsui.$space-button-focus-outline-gutter;
+  margin-inline-start: calc(-1 * #{awsui.$space-button-focus-outline-gutter});
 }
 
 // Stretch to the row track, else an empty control header collapses to ~1px, leaving a stray divider stub.