diff --git a/.gitignore b/.gitignore
index e7a4a6f0..97da2332 100644
--- a/.gitignore
+++ b/.gitignore
@@ -1,3 +1,5 @@
 # Built files
 build/
 docs/Doxygen/
+# Generated files
+src/backend/x64/mig/
diff --git a/CMakeLists.txt b/CMakeLists.txt
index 2aa9052a..cb68de0e 100644
--- a/CMakeLists.txt
+++ b/CMakeLists.txt
@@ -1,5 +1,5 @@
 cmake_minimum_required(VERSION 3.8)
-project(dynarmic CXX)
+project(dynarmic C CXX)
 
 # Determine if we're built as a subproject (using add_subdirectory)
 # or if this is the master project.
diff --git a/src/CMakeLists.txt b/src/CMakeLists.txt
index 7c4e3979..abf66c07 100644
--- a/src/CMakeLists.txt
+++ b/src/CMakeLists.txt
@@ -261,6 +261,31 @@ if (ARCHITECTURE_x86_64)
 
     if (WIN32)
         target_sources(dynarmic PRIVATE backend/x64/exception_handler_windows.cpp)
+    elseif (APPLE)
+        find_path(MACH_EXC_DEFS_DIR "mach/mach_exc.defs")
+        if (NOT MACH_EXC_DEFS_DIR)
+            message(WARNING "macOS fastmem disabled: unable to find mach/mach_exc.defs")
+            target_sources(dynarmic PRIVATE backend/x64/exception_handler_generic.cpp)
+        else()
+            message(STATUS "mach/mach_exc.defs location: ${MACH_EXC_DEFS_DIR}")
+            execute_process(
+                COMMAND
+                    mkdir -p "${CMAKE_CURRENT_SOURCE_DIR}/backend/x64/mig"
+                COMMAND
+                    mig
+                    -arch x86_64
+                    -user "${CMAKE_CURRENT_SOURCE_DIR}/backend/x64/mig/mach_exc_user.c"
+                    -header "${CMAKE_CURRENT_SOURCE_DIR}/backend/x64/mig/mach_exc_user.h"
+                    -server "${CMAKE_CURRENT_SOURCE_DIR}/backend/x64/mig/mach_exc_server.c"
+                    -sheader "${CMAKE_CURRENT_SOURCE_DIR}/backend/x64/mig/mach_exc_server.h"
+                    "${MACH_EXC_DEFS_DIR}/mach/mach_exc.defs"
+            )
+            target_sources(dynarmic PRIVATE
+                backend/x64/exception_handler_macos.cpp
+                backend/x64/mig/mach_exc_server.c
+                backend/x64/mig/mach_exc_server.h
+            )
+        endif()
     else()
         target_sources(dynarmic PRIVATE backend/x64/exception_handler_generic.cpp)
     endif()
diff --git a/src/backend/x64/exception_handler_macos.cpp b/src/backend/x64/exception_handler_macos.cpp
new file mode 100644
index 00000000..5d84fb21
--- /dev/null
+++ b/src/backend/x64/exception_handler_macos.cpp
@@ -0,0 +1,231 @@
+/* This file is part of the dynarmic project.
+ * Copyright (c) 2019 MerryMage
+ * This software may be used and distributed according to the terms of the GNU
+ * General Public License version 2 or any later version.
+ */
+
+#include "backend/x64/exception_handler.h"
+
+#include <mach/mach.h>
+#include <mach/message.h>
+
+#include <cstring>
+#include <functional>
+#include <memory>
+#include <mutex>
+#include <thread>
+#include <vector>
+
+#include <fmt/format.h>
+
+#include "backend/x64/block_of_code.h"
+#include "common/assert.h"
+#include "common/cast_util.h"
+#include "common/common_types.h"
+
+#define mig_external extern "C"
+#include "backend/x64/mig/mach_exc_server.h"
+
+namespace Dynarmic::Backend::X64 {
+
+namespace {
+
+struct CodeBlockInfo {
+    u64 code_begin, code_end;
+    std::function<FakeCall(u64)> cb;
+};
+
+struct MachMessage {
+    mach_msg_header_t head;
+    char data[2048]; ///< Arbitrary size
+};
+
+class MachHandler final {
+public:
+    MachHandler();
+    ~MachHandler();
+
+    kern_return_t HandleRequest(x86_thread_state64_t* thread_state);
+
+    void AddCodeBlock(CodeBlockInfo info);
+    void RemoveCodeBlock(u64 rip);
+
+private:
+    auto FindCodeBlockInfo(u64 rip) {
+        return std::find_if(code_block_infos.begin(), code_block_infos.end(), [&](const auto& x) { return x.code_begin <= rip && x.code_end > rip; });
+    }
+
+    std::vector<CodeBlockInfo> code_block_infos;
+    std::mutex code_block_infos_mutex;
+
+    std::thread thread;
+    mach_port_t server_port;
+
+    void MessagePump();
+};
+
+MachHandler::MachHandler() {
+    #define KCHECK(x) ASSERT_MSG((x) == KERN_SUCCESS, "dynarmic: macOS MachHandler: init failure at {}", #x)
+
+    KCHECK(mach_port_allocate(mach_task_self(), MACH_PORT_RIGHT_RECEIVE, &server_port));
+    KCHECK(mach_port_insert_right(mach_task_self(), server_port, server_port, MACH_MSG_TYPE_MAKE_SEND));
+    KCHECK(task_set_exception_ports(mach_task_self(), EXC_MASK_BAD_ACCESS, server_port, EXCEPTION_STATE | MACH_EXCEPTION_CODES, x86_THREAD_STATE64));
+
+    // The below doesn't actually work, and I'm not sure why; since this doesn't work we'll have a spurious error message upon shutdown.
+    mach_port_t prev;
+    KCHECK(mach_port_request_notification(mach_task_self(), server_port, MACH_NOTIFY_PORT_DESTROYED, 0, server_port, MACH_MSG_TYPE_MAKE_SEND_ONCE, &prev));
+
+    #undef KCHECK
+
+    thread = std::thread(&MachHandler::MessagePump, this);
+}
+
+MachHandler::~MachHandler() {
+    mach_port_destroy(mach_task_self(), server_port);
+    thread.join();
+}
+
+void MachHandler::MessagePump() {
+    mach_msg_return_t mr;
+    MachMessage request;
+    MachMessage reply;
+
+    while (true) {
+        mr = mach_msg(&request.head, MACH_RCV_MSG | MACH_RCV_LARGE, 0, sizeof(request), server_port, MACH_MSG_TIMEOUT_NONE, MACH_PORT_NULL);
+        if (mr != MACH_MSG_SUCCESS) {
+            fmt::print(stderr, "dynarmic: macOS MachHandler: Failed to receive mach message. error: {:#08x} ({})\n", mr, mach_error_string(mr));
+            return;
+        }
+
+        if (!mach_exc_server(&request.head, &reply.head)) {
+            fmt::print(stderr, "dynarmic: macOS MachHandler: Unexpected mach message\n");
+            return;
+        }
+
+        mr = mach_msg(&reply.head, MACH_SEND_MSG, reply.head.msgh_size, 0, MACH_PORT_NULL, MACH_MSG_TIMEOUT_NONE, MACH_PORT_NULL);
+        if (mr != MACH_MSG_SUCCESS){
+            fmt::print(stderr, "dynarmic: macOS MachHandler: Failed to send mach message. error: {:#08x} ({})\n", mr, mach_error_string(mr));
+            return;
+        }
+    }
+}
+
+kern_return_t MachHandler::HandleRequest(x86_thread_state64_t* ts) {
+    std::lock_guard<std::mutex> guard(code_block_infos_mutex);
+
+    const auto iter = FindCodeBlockInfo(ts->__rip);
+    if (iter == code_block_infos.end()) {
+        fmt::print(stderr, "dynarmic: macOS MachHandler: Exception was not in registered code blocks (rip {:#016x})\n", ts->__rip);
+        return KERN_FAILURE;
+    }
+
+    FakeCall fc = iter->cb(ts->__rip);
+
+    ts->__rsp -= sizeof(u64);
+    *Common::BitCast<u64*>(ts->__rsp) = fc.ret_rip;
+    ts->__rip = fc.call_rip;
+
+    return KERN_SUCCESS;
+}
+
+void MachHandler::AddCodeBlock(CodeBlockInfo cbi) {
+    std::lock_guard<std::mutex> guard(code_block_infos_mutex);
+    if (auto iter = FindCodeBlockInfo(cbi.code_begin); iter != code_block_infos.end()) {
+        code_block_infos.erase(iter);
+    }
+    code_block_infos.push_back(cbi);
+}
+
+void MachHandler::RemoveCodeBlock(u64 rip) {
+    std::lock_guard<std::mutex> guard(code_block_infos_mutex);
+    const auto iter = FindCodeBlockInfo(rip);
+    if (iter == code_block_infos.end()) {
+        return;
+    }
+    code_block_infos.erase(iter);
+}
+
+MachHandler mach_handler;
+
+} // anonymous namespace
+
+mig_external kern_return_t catch_mach_exception_raise(mach_port_t, mach_port_t, mach_port_t, exception_type_t, mach_exception_data_t, mach_msg_type_number_t) {
+    fmt::print(stderr, "dynarmic: Unexpected mach message: mach_exception_raise\n");
+    return KERN_FAILURE;
+}
+
+mig_external kern_return_t catch_mach_exception_raise_state_identity(mach_port_t, mach_port_t, mach_port_t, exception_type_t, mach_exception_data_t, mach_msg_type_number_t, int*, thread_state_t, mach_msg_type_number_t, thread_state_t, mach_msg_type_number_t*) {
+    fmt::print(stderr, "dynarmic: Unexpected mach message: mach_exception_raise_state_identity\n");
+    return KERN_FAILURE;
+}
+
+mig_external kern_return_t catch_mach_exception_raise_state(
+    mach_port_t /*exception_port*/,
+    exception_type_t exception,
+    const mach_exception_data_t /*code*/, // code[0] is as per kern_return.h, code[1] is rip.
+    mach_msg_type_number_t /*codeCnt*/,
+    int* flavor,
+    const thread_state_t old_state,
+    mach_msg_type_number_t old_stateCnt,
+    thread_state_t new_state,
+    mach_msg_type_number_t* new_stateCnt
+) {
+    if (!flavor || !new_stateCnt) {
+        fmt::print(stderr, "dynarmic: catch_mach_exception_raise_state: Invalid arguments.\n");
+        return KERN_INVALID_ARGUMENT;
+    }
+    if (*flavor != x86_THREAD_STATE64 || old_stateCnt != x86_THREAD_STATE64_COUNT || *new_stateCnt < x86_THREAD_STATE64_COUNT) {
+        fmt::print(stderr, "dynarmic: catch_mach_exception_raise_state: Unexpected flavor.\n");
+        return KERN_INVALID_ARGUMENT;
+    }
+    if (exception != EXC_BAD_ACCESS) {
+        fmt::print(stderr, "dynarmic: catch_mach_exception_raise_state: Unexpected exception type.\n");
+        return KERN_FAILURE;
+    }
+
+    x86_thread_state64_t* ts = reinterpret_cast<x86_thread_state64_t*>(new_state);
+    std::memcpy(ts, reinterpret_cast<const x86_thread_state64_t*>(old_state), sizeof(x86_thread_state64_t));
+    *new_stateCnt = x86_THREAD_STATE64_COUNT;
+
+    return mach_handler.HandleRequest(ts);
+}
+
+struct ExceptionHandler::Impl final {
+    Impl(BlockOfCode& code)
+        : code_begin(Common::BitCast<u64>(code.getCode()))
+        , code_end(code_begin + code.GetTotalCodeSize())
+    {}
+
+    void SetCallback(std::function<FakeCall(u64)> cb) {
+        CodeBlockInfo cbi;
+        cbi.code_begin = code_begin;
+        cbi.code_end = code_end;
+        cbi.cb = cb;
+        mach_handler.AddCodeBlock(cbi);
+    }
+
+    ~Impl() {
+        mach_handler.RemoveCodeBlock(code_begin);
+    }
+
+private:
+    u64 code_begin, code_end;
+};
+
+ExceptionHandler::ExceptionHandler() = default;
+
+ExceptionHandler::~ExceptionHandler() = default;
+
+void ExceptionHandler::Register(BlockOfCode& code) {
+    impl = std::make_unique<Impl>(code);
+}
+
+bool ExceptionHandler::SupportsFastmem() const noexcept {
+    return static_cast<bool>(impl);
+}
+
+void ExceptionHandler::SetFastmemCallback(std::function<FakeCall(u64)> cb) {
+    impl->SetCallback(cb);
+}
+
+} // namespace Dynarmic::Backend::X64