diff --git a/.changeset/lemon-pigs-mix.md b/.changeset/lemon-pigs-mix.md
new file mode 100644
index 00000000000..616ae88d36e
--- /dev/null
+++ b/.changeset/lemon-pigs-mix.md
@@ -0,0 +1,5 @@
+---
+'@primer/react': patch
+---
+
+Adds new a11y improvements to Pagination.
diff --git a/src/Pagination/model.tsx b/src/Pagination/model.tsx
index 1ba6f323b18..914ab52d24f 100644
--- a/src/Pagination/model.tsx
+++ b/src/Pagination/model.tsx
@@ -65,6 +65,12 @@ export function buildPaginationModel(
     for (let idx = 0; idx < sorted.length; idx++) {
       const num = sorted[idx]
       const selected = num === currentPage
+      const last = sorted[idx - 1]
+      const next = sorted[idx + 1]
+      const lastDelta = num - last
+      const nextDelta = num - next
+      const precedesBreak = nextDelta !== -1
+
       if (idx === 0) {
         if (num !== 1) {
           // If the first page isn't page one,
@@ -78,15 +84,15 @@ export function buildPaginationModel(
           type: 'NUM',
           num,
           selected,
+          precedesBreak,
         })
       } else {
-        const last = sorted[idx - 1]
-        const delta = num - last
-        if (delta === 1) {
+        if (lastDelta === 1) {
           pages.push({
             type: 'NUM',
             num,
             selected,
+            precedesBreak,
           })
         } else {
           // We skipped some, so add a break
@@ -98,6 +104,7 @@ export function buildPaginationModel(
             type: 'NUM',
             num,
             selected,
+            precedesBreak: false,
           })
         }
       }
@@ -124,6 +131,7 @@ type PageType = {
   num: number
   disabled?: boolean
   selected?: boolean
+  precedesBreak?: boolean
 }
 
 export function buildComponentData(
@@ -169,11 +177,15 @@ export function buildComponentData(
     case 'NUM': {
       key = `page-${page.num}`
       content = String(page.num)
-      if (page.selected) {
-        Object.assign(props, {as: 'em', 'aria-current': 'page'})
-      } else {
-        Object.assign(props, {href: hrefBuilder(page.num), 'aria-label': `Page ${page.num}`, onClick})
-      }
+      Object.assign(props, {
+        href: hrefBuilder(page.num),
+        // We append "..." to the aria-label for pages that preceed a break because screen readers will
+        // change the tone the text is read in.
+        // This is a slightly nicer experience than skipping a bunch of numbers unexpectedly.
+        'aria-label': `Page ${page.num}${page.precedesBreak ? '...' : ''}`,
+        onClick,
+        'aria-current': page.selected ? 'page' : undefined,
+      })
       break
     }
     case 'BREAK': {
diff --git a/src/__tests__/Pagination/PaginationModel.test.tsx b/src/__tests__/Pagination/PaginationModel.test.tsx
index a119873f346..3a3ba2e6273 100644
--- a/src/__tests__/Pagination/PaginationModel.test.tsx
+++ b/src/__tests__/Pagination/PaginationModel.test.tsx
@@ -60,7 +60,7 @@ describe('Pagination model', () => {
     const slice = last(model, 5)
 
     const expected = [
-      {type: 'NUM'},
+      {type: 'NUM', precedesBreak: true},
       {type: 'BREAK'},
       {type: 'NUM', num: 9},
       {type: 'NUM', num: 10},
@@ -74,11 +74,11 @@ describe('Pagination model', () => {
     const model = buildPaginationModel(10, 5, true, 1, 1)
     const expected = [
       {type: 'PREV', num: 4},
-      {type: 'NUM', num: 1},
+      {type: 'NUM', num: 1, precedesBreak: true},
       {type: 'BREAK'},
       {type: 'NUM', num: 4},
       {type: 'NUM', num: 5, selected: true},
-      {type: 'NUM', num: 6},
+      {type: 'NUM', num: 6, precedesBreak: true},
       {type: 'BREAK'},
       {type: 'NUM', num: 10},
       {type: 'NEXT', num: 6},
@@ -95,7 +95,7 @@ describe('Pagination model', () => {
       {type: 'NUM', num: 3},
       // normally with a surround of 1, only 1 and 3 would be shown
       // however, since 1 was already shown, we extend to 4
-      {type: 'NUM', num: 4},
+      {type: 'NUM', num: 4, precedesBreak: true},
       {type: 'BREAK'},
     ]
     expect(first(model, 6)).toMatchObject(expected)
@@ -123,7 +123,7 @@ describe('Pagination model', () => {
       {type: 'BREAK', num: 1},
       {type: 'NUM', num: 4},
       {type: 'NUM', num: 5, selected: true},
-      {type: 'NUM', num: 6},
+      {type: 'NUM', num: 6, precedesBreak: true},
       {type: 'BREAK', num: 10},
       {type: 'NEXT'},
     ]
diff --git a/src/__tests__/Pagination/__snapshots__/Pagination.test.tsx.snap b/src/__tests__/Pagination/__snapshots__/Pagination.test.tsx.snap
index 7197e07d306..889609579e2 100644
--- a/src/__tests__/Pagination/__snapshots__/Pagination.test.tsx.snap
+++ b/src/__tests__/Pagination/__snapshots__/Pagination.test.tsx.snap
@@ -129,12 +129,15 @@ exports[`Pagination renders consistently 1`] = `
     >
       Previous
     </span>
-    <em
+    <a
       aria-current="page"
+      aria-label="Page 1"
       className="c2"
+      href="#1"
+      onClick={[Function]}
     >
       1
-    </em>
+    </a>
     <a
       aria-label="Page 2"
       className="c2"
@@ -168,7 +171,7 @@ exports[`Pagination renders consistently 1`] = `
       5
     </a>
     <a
-      aria-label="Page 6"
+      aria-label="Page 6..."
       className="c2"
       href="#6"
       onClick={[Function]}