diff --git a/soh/soh/Enhancements/mods.cpp b/soh/soh/Enhancements/mods.cpp
index d7123c570..275057bcf 100644
--- a/soh/soh/Enhancements/mods.cpp
+++ b/soh/soh/Enhancements/mods.cpp
@@ -1127,6 +1127,17 @@ void RegisterRandomizedEnemySizes() {
         }
 
         Actor_SetScale(actor, actor->scale.z * randomScale);
+
+        if (CVarGetInteger("gEnemySizeScalesHealth", 0) && (actor->category == ACTORCAT_ENEMY)) {
+            // Scale the health based on a smaller factor than randomScale
+            float healthScalingFactor = 0.8f; // Adjust this factor as needed
+            float scaledHealth = actor->colChkInfo.health * (randomScale * healthScalingFactor);
+
+            // Ensure the scaled health doesn't go below zero
+            actor->colChkInfo.health = fmax(scaledHealth, 1.0f);
+        } else {
+            return;
+        }
     });
 }
 
diff --git a/soh/soh/SohMenuBar.cpp b/soh/soh/SohMenuBar.cpp
index e46051969..7c1f51cf1 100644
--- a/soh/soh/SohMenuBar.cpp
+++ b/soh/soh/SohMenuBar.cpp
@@ -1182,6 +1182,11 @@ void DrawEnhancementsMenu() {
             UIWidgets::PaddedEnhancementCheckbox("Randomized Enemy Sizes", "gRandomizedEnemySizes", true, false);
             UIWidgets::Tooltip("Enemies and Bosses spawn with random sizes.");
 
+            if (CVarGetInteger("gRandomizedEnemySizes", 0)) {
+                UIWidgets::EnhancementCheckbox("Scale Health with Size", "gEnemySizeScalesHealth");
+                UIWidgets::Tooltip("Scales normal enemies health with their randomized size. *This will NOT affect bosses*");
+            }
+
             UIWidgets::PaddedEnhancementCheckbox("Ivan the Fairy (Coop Mode)", "gIvanCoopModeEnabled", true, false);
             UIWidgets::Tooltip("Enables Ivan the Fairy upon the next map change. Player 2 can control Ivan and "
                                 "press the C-Buttons to use items and mess with Player 1!");