diff --git a/CHANGELOG.md b/CHANGELOG.md
index 02a45c4c689..26ffe75c822 100644
--- a/CHANGELOG.md
+++ b/CHANGELOG.md
@@ -14,6 +14,8 @@ For notes on migrating to 2.x / 0.200.x see [the upgrade guide](doc/upgrade-to-2
 
 ### :rocket: Features
 
+* feat(opentelemetry-core,sdk-trace-base): append `exception.cause` chain to `ATTR_EXCEPTION_STACKTRACE` [#6423](https://github.com/open-telemetry/opentelemetry-js/issues/6423) @abhisheksurve45
+
 ### :bug: Bug Fixes
 
 ### :books: Documentation
diff --git a/experimental/CHANGELOG.md b/experimental/CHANGELOG.md
index 5ebf2bd8c14..0e2841e6404 100644
--- a/experimental/CHANGELOG.md
+++ b/experimental/CHANGELOG.md
@@ -10,6 +10,7 @@ For notes on migrating to 2.x / 0.200.x see [the upgrade guide](doc/upgrade-to-2
 
 ### :rocket: Features
 
+* feat(sdk-logs): append `exception.cause` chain to `ATTR_EXCEPTION_STACKTRACE` [#6423](https://github.com/open-telemetry/opentelemetry-js/issues/6423) @abhisheksurve45
 * feat(sdk-node): wire attribute_keys from declarative configuration to ViewOptions.attributesProcessors [#6427](https://github.com/open-telemetry/opentelemetry-js/issues/6427) @ravitheja4531-cell
 * feat(sdk-node): set TracerProvider in startNodeSDK() [#6607](https://github.com/open-telemetry/opentelemetry-js/pull/6607) @maryliag
 
diff --git a/experimental/packages/sdk-logs/src/LogRecordImpl.ts b/experimental/packages/sdk-logs/src/LogRecordImpl.ts
index c71f2646023..6bbb3cde051 100644
--- a/experimental/packages/sdk-logs/src/LogRecordImpl.ts
+++ b/experimental/packages/sdk-logs/src/LogRecordImpl.ts
@@ -12,7 +12,7 @@ import type {
 } from '@opentelemetry/api-logs';
 import * as api from '@opentelemetry/api';
 import type { InstrumentationScope } from '@opentelemetry/core';
-import { timeInputToHrTime } from '@opentelemetry/core';
+import { buildExceptionCauseChain, timeInputToHrTime } from '@opentelemetry/core';
 import type { Resource } from '@opentelemetry/resources';
 import {
   ATTR_EXCEPTION_MESSAGE,
@@ -274,7 +274,13 @@ export class LogRecordImpl implements ReadableLogRecord {
 
       if (exceptionObj.stack) {
         if (!Object.hasOwn(this.attributes, ATTR_EXCEPTION_STACKTRACE)) {
-          this.setAttribute(ATTR_EXCEPTION_STACKTRACE, exceptionObj.stack);
+          const causeChain = buildExceptionCauseChain(
+            (exceptionObj as { cause?: unknown }).cause
+          );
+          this.setAttribute(
+            ATTR_EXCEPTION_STACKTRACE,
+            exceptionObj.stack + causeChain
+          );
         }
         hasMinimumAttributes = true;
       }
diff --git a/experimental/packages/sdk-logs/test/common/LogRecord.test.ts b/experimental/packages/sdk-logs/test/common/LogRecord.test.ts
index 649604a7f2d..4f7cc8ba11a 100644
--- a/experimental/packages/sdk-logs/test/common/LogRecord.test.ts
+++ b/experimental/packages/sdk-logs/test/common/LogRecord.test.ts
@@ -220,6 +220,39 @@ describe('LogRecord', () => {
 
       assert.strictEqual(logRecord.attributes[ATTR_EXCEPTION_TYPE], '12');
     });
+
+    it('should append cause stack to stacktrace', () => {
+      const cause = new Error('inner');
+      cause.stack = 'Error: inner\n    at inner:1:1';
+      const outer = new Error('outer') as Error & { cause?: unknown };
+      outer.stack = 'Error: outer\n    at outer:1:1';
+      outer.cause = cause;
+
+      const { logRecord } = setup(undefined, { exception: outer });
+
+      assert.strictEqual(
+        logRecord.attributes[ATTR_EXCEPTION_STACKTRACE],
+        'Error: outer\n    at outer:1:1\nCaused by: Error: inner\n    at inner:1:1'
+      );
+    });
+
+    it('should walk a multi-level cause chain in stacktrace', () => {
+      const root = new Error('root') as any;
+      root.stack = 'Error: root\n    at root:1:1';
+      const mid = new Error('mid') as any;
+      mid.stack = 'Error: mid\n    at mid:1:1';
+      mid.cause = root;
+      const top = new Error('top') as any;
+      top.stack = 'Error: top\n    at top:1:1';
+      top.cause = mid;
+
+      const { logRecord } = setup(undefined, { exception: top });
+
+      assert.strictEqual(
+        logRecord.attributes[ATTR_EXCEPTION_STACKTRACE],
+        'Error: top\n    at top:1:1\nCaused by: Error: mid\n    at mid:1:1\nCaused by: Error: root\n    at root:1:1'
+      );
+    });
   });
 
   describe('setAttribute', () => {
diff --git a/packages/opentelemetry-core/src/common/exception.ts b/packages/opentelemetry-core/src/common/exception.ts
new file mode 100644
index 00000000000..a52ba4d6052
--- /dev/null
+++ b/packages/opentelemetry-core/src/common/exception.ts
@@ -0,0 +1,19 @@
+/*
+ * Copyright The OpenTelemetry Authors
+ * SPDX-License-Identifier: Apache-2.0
+ */
+
+export function buildExceptionCauseChain(cause: unknown): string {
+  const visited = new Set<unknown>();
+  let result = '';
+  let current = cause;
+  while (current && typeof current === 'object' && !visited.has(current)) {
+    visited.add(current);
+    const c = current as { stack?: string; cause?: unknown };
+    if (c.stack) {
+      result += `\nCaused by: ${c.stack}`;
+    }
+    current = c.cause;
+  }
+  return result;
+}
diff --git a/packages/opentelemetry-core/src/index.ts b/packages/opentelemetry-core/src/index.ts
index 81456120b4a..26c170169a1 100644
--- a/packages/opentelemetry-core/src/index.ts
+++ b/packages/opentelemetry-core/src/index.ts
@@ -7,6 +7,7 @@ export { W3CBaggagePropagator } from './baggage/propagation/W3CBaggagePropagator
 export { AnchoredClock } from './common/anchored-clock';
 export type { Clock } from './common/anchored-clock';
 export { isAttributeValue, sanitizeAttributes } from './common/attributes';
+export { buildExceptionCauseChain } from './common/exception';
 export {
   globalErrorHandler,
   setGlobalErrorHandler,
diff --git a/packages/opentelemetry-core/test/common/exception.test.ts b/packages/opentelemetry-core/test/common/exception.test.ts
new file mode 100644
index 00000000000..948591170cd
--- /dev/null
+++ b/packages/opentelemetry-core/test/common/exception.test.ts
@@ -0,0 +1,70 @@
+/*
+ * Copyright The OpenTelemetry Authors
+ * SPDX-License-Identifier: Apache-2.0
+ */
+
+import * as assert from 'assert';
+import { buildExceptionCauseChain } from '../../src/common/exception';
+
+describe('exception', () => {
+  describe('#buildExceptionCauseChain', () => {
+    it('should return empty string when cause is undefined', () => {
+      assert.strictEqual(buildExceptionCauseChain(undefined), '');
+    });
+
+    it('should return empty string when cause is null', () => {
+      assert.strictEqual(buildExceptionCauseChain(null), '');
+    });
+
+    it('should return empty string when cause is a primitive', () => {
+      assert.strictEqual(buildExceptionCauseChain('string cause'), '');
+      assert.strictEqual(buildExceptionCauseChain(42), '');
+    });
+
+    it('should append cause stack when cause has a stack', () => {
+      const cause = new Error('inner error');
+      cause.stack = 'Error: inner error\n    at inner:1:1';
+      const result = buildExceptionCauseChain(cause);
+      assert.strictEqual(
+        result,
+        '\nCaused by: Error: inner error\n    at inner:1:1'
+      );
+    });
+
+    it('should skip cause silently when cause has no stack', () => {
+      const cause = { message: 'no stack here' };
+      const result = buildExceptionCauseChain(cause);
+      assert.strictEqual(result, '');
+    });
+
+    it('should walk a multi-level cause chain', () => {
+      const root = new Error('root');
+      root.stack = 'Error: root\n    at root:1:1';
+
+      const mid = new Error('mid');
+      mid.stack = 'Error: mid\n    at mid:1:1';
+      (mid as any).cause = root;
+
+      const result = buildExceptionCauseChain(mid);
+      assert.strictEqual(
+        result,
+        '\nCaused by: Error: mid\n    at mid:1:1\nCaused by: Error: root\n    at root:1:1'
+      );
+    });
+
+    it('should terminate on circular cause references without infinite loop', () => {
+      const a: any = new Error('a');
+      a.stack = 'Error: a\n    at a:1:1';
+      const b: any = new Error('b');
+      b.stack = 'Error: b\n    at b:1:1';
+      a.cause = b;
+      b.cause = a;
+
+      const result = buildExceptionCauseChain(a);
+      assert.strictEqual(
+        result,
+        '\nCaused by: Error: a\n    at a:1:1\nCaused by: Error: b\n    at b:1:1'
+      );
+    });
+  });
+});
diff --git a/packages/opentelemetry-sdk-trace-base/src/Span.ts b/packages/opentelemetry-sdk-trace-base/src/Span.ts
index 7dab28618c2..e78e3b55c23 100644
--- a/packages/opentelemetry-sdk-trace-base/src/Span.ts
+++ b/packages/opentelemetry-sdk-trace-base/src/Span.ts
@@ -21,6 +21,7 @@ import { diag, SpanStatusCode } from '@opentelemetry/api';
 import type { InstrumentationScope } from '@opentelemetry/core';
 import {
   addHrTimes,
+  buildExceptionCauseChain,
   millisToHrTime,
   hrTime,
   hrTimeDuration,
@@ -432,7 +433,10 @@ export class SpanImpl implements Span {
         attributes[ATTR_EXCEPTION_MESSAGE] = exception.message;
       }
       if (exception.stack) {
-        attributes[ATTR_EXCEPTION_STACKTRACE] = exception.stack;
+        const causeChain = buildExceptionCauseChain(
+          (exception as { cause?: unknown }).cause
+        );
+        attributes[ATTR_EXCEPTION_STACKTRACE] = exception.stack + causeChain;
       }
     }
 
diff --git a/packages/opentelemetry-sdk-trace-base/test/common/Span.test.ts b/packages/opentelemetry-sdk-trace-base/test/common/Span.test.ts
index c3d68f4ab0e..2c8c5415947 100644
--- a/packages/opentelemetry-sdk-trace-base/test/common/Span.test.ts
+++ b/packages/opentelemetry-sdk-trace-base/test/common/Span.test.ts
@@ -1919,6 +1919,61 @@ describe('Span', () => {
       });
     });
 
+    describe('when exception has a cause', () => {
+      it('should append cause stack to stacktrace', () => {
+        const span = new SpanImpl({
+          scope: tracer.instrumentationScope,
+          resource: tracer['_resource'],
+          context: ROOT_CONTEXT,
+          spanContext,
+          name,
+          kind: SpanKind.CLIENT,
+          spanLimits: tracer.getSpanLimits(),
+          spanProcessor: tracer['_spanProcessor'],
+        });
+        const cause = new Error('inner');
+        cause.stack = 'Error: inner\n    at inner:1:1';
+        const outer = new Error('outer') as Error & { cause?: unknown };
+        outer.stack = 'Error: outer\n    at outer:1:1';
+        outer.cause = cause;
+
+        span.recordException(outer);
+        const event = span.events[0];
+        assert.strictEqual(
+          event.attributes?.[ATTR_EXCEPTION_STACKTRACE],
+          'Error: outer\n    at outer:1:1\nCaused by: Error: inner\n    at inner:1:1'
+        );
+      });
+
+      it('should walk a multi-level cause chain', () => {
+        const span = new SpanImpl({
+          scope: tracer.instrumentationScope,
+          resource: tracer['_resource'],
+          context: ROOT_CONTEXT,
+          spanContext,
+          name,
+          kind: SpanKind.CLIENT,
+          spanLimits: tracer.getSpanLimits(),
+          spanProcessor: tracer['_spanProcessor'],
+        });
+        const root = new Error('root') as any;
+        root.stack = 'Error: root\n    at root:1:1';
+        const mid = new Error('mid') as any;
+        mid.stack = 'Error: mid\n    at mid:1:1';
+        mid.cause = root;
+        const top = new Error('top') as any;
+        top.stack = 'Error: top\n    at top:1:1';
+        top.cause = mid;
+
+        span.recordException(top);
+        const event = span.events[0];
+        assert.strictEqual(
+          event.attributes?.[ATTR_EXCEPTION_STACKTRACE],
+          'Error: top\n    at top:1:1\nCaused by: Error: mid\n    at mid:1:1\nCaused by: Error: root\n    at root:1:1'
+        );
+      });
+    });
+
     describe('when attributes are specified', () => {
       it('should store specified attributes', () => {
         const span = new SpanImpl({