diff --git a/tests/test_ulid.py b/tests/test_ulid.py
index 11ae933..d36e556 100644
--- a/tests/test_ulid.py
+++ b/tests/test_ulid.py
@@ -110,6 +110,7 @@ def test_idempotency() -> None:
     assert ULID.from_bytes(ulid.bytes) == ulid
     assert ULID.from_str(str(ulid)) == ulid
     assert ULID.from_uuid(ulid.to_uuid()) == ulid
+    assert ULID.from_uuidv7(ulid.to_uuidv7(compliant=False)) == ulid
     assert ULID.from_int(int(ulid)) == ulid
     assert ULID.from_hex(ulid.hex) == ulid
     assert ULID.parse(ulid) == ulid
@@ -131,6 +132,117 @@ def test_to_uuid4() -> None:
     assert uuid.version == 4  # noqa: PLR2004
 
 
+def test_to_uuidv7_non_compliant() -> None:
+    """Test non-compliant UUIDv7 conversion preserves all randomness."""
+    ulid = ULID()
+    uuid7 = ulid.to_uuidv7(compliant=False)
+    assert isinstance(uuid7, uuid.UUID)
+    # Non-compliant may not have version/variant bits set correctly
+    # but should preserve all data for perfect round-trip
+
+
+def test_to_uuidv7_compliant() -> None:
+    """Test compliant UUIDv7 has correct version and variant bits."""
+    ulid = ULID()
+    uuid7 = ulid.to_uuidv7(compliant=True)
+    assert isinstance(uuid7, uuid.UUID)
+    assert uuid7.version == 7  # noqa: PLR2004
+    # Check variant bits are RFC 4122 compliant (10xx xxxx)
+    # The variant field is in byte 8 (bits 64-65)
+    variant_byte = uuid7.bytes[8]
+    assert (variant_byte & 0xC0) == 0x80  # Variant bits should be 0b10xxxxxx
+
+
+def test_uuidv7_perfect_roundtrip() -> None:
+    """Test perfect round-trip conversion with compliant=False."""
+    ulid = ULID()
+    uuid7 = ulid.to_uuidv7(compliant=False)
+    ulid_restored = ULID.from_uuidv7(uuid7)
+    # Perfect round-trip: all 128 bits should be identical
+    assert ulid_restored == ulid
+    assert ulid_restored.bytes == ulid.bytes
+    assert ulid_restored.milliseconds == ulid.milliseconds
+
+
+def test_uuidv7_compliant_roundtrip() -> None:
+    """Test round-trip with compliant=True preserves timestamp but loses some randomness."""
+    ulid = ULID()
+    uuid7 = ulid.to_uuidv7(compliant=True)
+    ulid_restored = ULID.from_uuidv7(uuid7)
+    # Timestamp should be perfectly preserved
+    assert ulid_restored.milliseconds == ulid.milliseconds
+    # Full ULID won't match due to lost randomness in version/variant bits (6 bits lost)
+    assert ulid_restored.bytes != ulid.bytes
+
+
+def test_uuidv7_timestamp_preservation() -> None:
+    """Test that UUIDv7 conversion preserves timestamp accurately."""
+    # Test with a specific known timestamp
+    test_timestamp = 1699564800.123  # 2023-11-10 00:00:00.123 UTC
+    ulid = ULID.from_timestamp(test_timestamp)
+
+    # Test both compliant and non-compliant modes
+    for compliant in [False, True]:
+        uuid7 = ulid.to_uuidv7(compliant=compliant)
+        ulid_from_uuid7 = ULID.from_uuidv7(uuid7)
+
+        # Check timestamp is perfectly preserved (exact millisecond match)
+        assert ulid_from_uuid7.milliseconds == ulid.milliseconds
+        assert abs(ulid_from_uuid7.timestamp - test_timestamp) < 0.001
+
+
+def test_uuidv7_monotonic_ordering() -> None:
+    """Test that UUIDv7s maintain monotonic ordering like ULIDs."""
+    with freeze_time() as frozen_time:
+        ulids = []
+        uuid7s = []
+        for i in range(10):
+            ulid = ULID()
+            ulids.append(ulid)
+            uuid7s.append(ulid.to_uuidv7(compliant=False))
+            frozen_time.tick()
+
+        # Both ULIDs and UUID7s should be sorted
+        assert_sorted(ulids)
+        assert_sorted([u.bytes for u in uuid7s])
+
+
+@freeze_time()
+def test_uuidv7_same_millisecond() -> None:
+    """Test UUIDv7 conversion with multiple ULIDs in same millisecond."""
+    ulids = [ULID() for _ in range(100)]
+    uuid7s = [u.to_uuidv7(compliant=False) for u in ulids]
+
+    # All should maintain monotonic ordering
+    assert_sorted(ulids)
+    assert_sorted([u.bytes for u in uuid7s])
+
+    # Perfect round-trip for all
+    for ulid, uuid7 in zip(ulids, uuid7s):
+        assert ULID.from_uuidv7(uuid7) == ulid
+
+
+def test_from_uuidv7_with_external_uuid() -> None:
+    """Test creating ULID from an external UUIDv7."""
+    # Create a UUIDv7 with known timestamp (compliant format)
+    # This simulates a UUIDv7 created by another system
+    timestamp_ms = 1699564800500  # 2023-11-10 00:00:00.500 UTC
+
+    # Build a compliant UUIDv7: [48-bit timestamp_ms][4-bit version][12-bit rand_a][2-bit variant][62-bit rand_b]
+    # For this test, we'll use some random values for rand_a and rand_b
+    rand_a = 0xABC  # 12 bits
+    rand_b = 0x1234567890ABCDEF  # 62 bits (only bottom 62 bits will be used)
+    rand_b = rand_b & ((1 << 62) - 1)  # Mask to 62 bits
+
+    uuid_int = (timestamp_ms << 80) | (0x7 << 76) | (rand_a << 64) | (0x2 << 62) | rand_b
+    uuid7 = uuid.UUID(bytes=uuid_int.to_bytes(16, byteorder="big"))
+
+    ulid = ULID.from_uuidv7(uuid7)
+
+    # Check timestamp is correctly extracted (should be exact since it's in milliseconds)
+    assert ulid.milliseconds == timestamp_ms
+
+
 def test_hash() -> None:
     ulid1 = ULID()
     ulid2 = ULID()
diff --git a/ulid/__init__.py b/ulid/__init__.py
index d327385..90bc545 100644
--- a/ulid/__init__.py
+++ b/ulid/__init__.py
@@ -281,6 +281,84 @@ def to_uuid4(self) -> uuid.UUID:
         """
         return uuid.UUID(bytes=self.bytes, version=4)
 
+    def to_uuidv7(self, compliant: bool = False) -> uuid.UUID:
+        """Convert the :class:`ULID` to a UUIDv7 (:class:`uuid.UUID` version 7).
+
+        UUIDv7 encodes a Unix timestamp in milliseconds in the first 48 bits (just like ULID).
+        The timestamp is always transparently preserved regardless of compliant mode.
+
+        Args:
+            compliant: If True, sets RFC 4122 version (0x7) and variant (0b10) bits,
+                      losing 6 bits of randomness. If False (default), preserves all 80 bits
+                      of randomness by clobbering version/variant bits, enabling perfect
+                      round-trip conversion. Most tools (PostgreSQL, standard libraries)
+                      accept non-compliant UUIDv7s.
+
+        Examples:
+
+            >>> ulid = ULID()
+            >>> uuid7 = ulid.to_uuidv7()  # Perfect round-trip
+            >>> assert ULID.from_uuidv7(uuid7) == ulid
+            >>> uuid7_compliant = ulid.to_uuidv7(compliant=True)  # RFC 4122 compliant
+            >>> uuid7_compliant.version
+            7
+        """
+        # ULID:   [48 bits timestamp_ms][80 bits randomness]
+        # UUIDv7: [48 bits timestamp_ms][4 bits ver][12 bits rand_a][2 bits var][62 bits rand_b]
+
+        timestamp_ms = self.milliseconds
+
+        # Get the 80 bits of randomness from ULID
+        randomness_bits = int.from_bytes(self.bytes[6:], byteorder="big")
+
+        if compliant:
+            # RFC 4122 compliant: set version and variant bits, losing 6 bits of randomness
+            # Extract 74 bits of randomness (losing 6 bits for version/variant)
+            rand_a = (randomness_bits >> 68) & 0xFFF  # Top 12 bits
+            rand_b = randomness_bits & ((1 << 62) - 1)  # Bottom 62 bits
+
+            # Build UUIDv7: [48-bit timestamp_ms][4-bit version][12-bit rand_a][2-bit variant][62-bit rand_b]
+            uuid_int = (timestamp_ms << 80) | (0x7 << 76) | (rand_a << 64) | (0x2 << 62) | rand_b
+        else:
+            # Non-compliant: preserve all 80 bits of randomness for perfect round-trip
+            # Build UUIDv7: [48-bit timestamp_ms][80-bit randomness] (clobbers version/variant)
+            uuid_int = (timestamp_ms << 80) | randomness_bits
+
+        uuid_bytes = uuid_int.to_bytes(16, byteorder="big")
+        return uuid.UUID(bytes=uuid_bytes)
+
+    @classmethod
+    @validate_type(uuid.UUID)
+    def from_uuidv7(cls, value: uuid.UUID) -> Self:
+        """Create a new :class:`ULID` from a UUIDv7 (:class:`uuid.UUID` version 7).
+
+        Extracts the timestamp from the UUIDv7's first 48 bits (milliseconds since epoch)
+        and the remaining 80 bits as randomness. The timestamp is always transparently
+        preserved, providing perfect round-trip conversion with :meth:`to_uuidv7`.
+
+        Examples:
+
+            >>> uuid7 = uuid.UUID('01936c5e-f4c0-7000-8000-000000000000')
+            >>> ulid = ULID.from_uuidv7(uuid7)
+            >>> ulid.datetime
+            datetime.datetime(2025, 11, 10, ...)
+        """
+        uuid_int = int.from_bytes(value.bytes, byteorder="big")
+
+        # Extract timestamp from UUIDv7 layout (always in first 48 bits)
+        # Bits 0-47: timestamp_ms (48 bits)
+        timestamp_ms = uuid_int >> 80
+
+        # Extract all 80 bits after the timestamp (bits 48-127) as randomness
+        # This includes version/variant bits if present, enabling perfect round-trip
+        randomness_bits = uuid_int & ((1 << 80) - 1)
+
+        # Build ULID bytes: [48-bit timestamp][80-bit randomness]
+        timestamp_bytes = timestamp_ms.to_bytes(6, byteorder="big")
+        randomness_bytes = randomness_bits.to_bytes(10, byteorder="big")
+
+        return cls.from_bytes(timestamp_bytes + randomness_bytes)
+
     def __repr__(self) -> str:
         return f"ULID({self!s})"