diff --git a/README.md b/README.md
index fa33f6b343..9cd1f61343 100644
--- a/README.md
+++ b/README.md
@@ -271,6 +271,18 @@ result = md.convert("test.xlsx")
 print(result.markdown)
 ```
 
+For PDFs containing rotated text, the built-in PDF converter accepts
+`pdf_char_dir_rotated="btt"` (bottom-to-top) or `"ttb"` (top-to-bottom):
+
+```python
+result = md.convert("rotated.pdf", pdf_char_dir_rotated="btt")
+```
+
+An explicit direction uses pdfplumber output for both text and table pages.
+Omitting the option or passing `None` retains the default extraction behavior.
+Other values raise a conversion error. The option controls character order;
+table column detection and multi-line header layout follow the existing rules.
+
 Document Intelligence conversion in Python:
 
 ```python
diff --git a/packages/markitdown/src/markitdown/converters/_pdf_converter.py b/packages/markitdown/src/markitdown/converters/_pdf_converter.py
index ffbcbd990c..3ca0738a0a 100644
--- a/packages/markitdown/src/markitdown/converters/_pdf_converter.py
+++ b/packages/markitdown/src/markitdown/converters/_pdf_converter.py
@@ -117,7 +117,9 @@ def fmt_row(row: list[str]) -> str:
     return "\n".join(md)
 
 
-def _extract_form_content_from_words(page: Any) -> str | None:
+def _extract_form_content_from_words(
+    page: Any, *, char_dir_rotated: str | None = None
+) -> str | None:
     """
     Extract form-style content from a PDF page by analyzing word positions.
     This handles borderless forms/tables where words are aligned in columns.
@@ -129,7 +131,14 @@ def _extract_form_content_from_words(page: Any) -> str | None:
     Returns None if the page doesn't appear to be a form-style document,
     indicating that pdfminer should be used instead for better text spacing.
     """
-    words = page.extract_words(keep_blank_chars=True, x_tolerance=3, y_tolerance=3)
+    extract_words_kwargs: dict[str, Any] = {
+        "keep_blank_chars": True,
+        "x_tolerance": 3,
+        "y_tolerance": 3,
+    }
+    if char_dir_rotated is not None:
+        extract_words_kwargs["char_dir_rotated"] = char_dir_rotated
+    words = page.extract_words(**extract_words_kwargs)
     if not words:
         return None
 
@@ -536,6 +545,13 @@ def convert(
 
         assert isinstance(file_stream, io.IOBase)
 
+        char_dir_rotated = kwargs.get("pdf_char_dir_rotated")
+        if char_dir_rotated not in (None, "ttb", "btt"):
+            raise ValueError("pdf_char_dir_rotated must be 'ttb', 'btt', or None")
+        extract_text_kwargs: dict[str, Any] = {}
+        if char_dir_rotated is not None:
+            extract_text_kwargs["char_dir_rotated"] = char_dir_rotated
+
         # Read file stream into BytesIO for compatibility with pdfplumber
         pdf_bytes = io.BytesIO(file_stream.read())
 
@@ -551,7 +567,9 @@ def convert(
 
             with pdfplumber.open(pdf_bytes) as pdf:
                 for page_idx, page in enumerate(pdf.pages):
-                    page_content = _extract_form_content_from_words(page)
+                    page_content = _extract_form_content_from_words(
+                        page, **extract_text_kwargs
+                    )
 
                     if page_content is not None:
                         form_page_count += 1
@@ -559,27 +577,28 @@ def convert(
                             markdown_chunks.append(page_content)
                     else:
                         plain_page_indices.append(page_idx)
-                        text = page.extract_text()
+                        text = page.extract_text(**extract_text_kwargs)
                         if text and text.strip():
                             markdown_chunks.append(text.strip())
 
                     page.close()  # Free cached page data immediately
 
-            # If no pages had form-style content, use pdfminer for
-            # the whole document (better text spacing for prose).
-            if form_page_count == 0:
+            # 显式指定旋转方向时，保留 pdfplumber 的提取结果。
+            if form_page_count == 0 and char_dir_rotated is None:
                 pdf_bytes.seek(0)
                 markdown = pdfminer.high_level.extract_text(pdf_bytes)
             else:
                 markdown = "\n\n".join(markdown_chunks).strip()
 
         except Exception:
+            if char_dir_rotated is not None:
+                raise
             # Fallback if pdfplumber fails
             pdf_bytes.seek(0)
             markdown = pdfminer.high_level.extract_text(pdf_bytes)
 
         # Fallback if still empty
-        if not markdown:
+        if not markdown and char_dir_rotated is None:
             pdf_bytes.seek(0)
             markdown = pdfminer.high_level.extract_text(pdf_bytes)
 
diff --git a/packages/markitdown/tests/README.md b/packages/markitdown/tests/README.md
index 86fd8f4661..8c0b1b5cdb 100644
--- a/packages/markitdown/tests/README.md
+++ b/packages/markitdown/tests/README.md
@@ -59,3 +59,9 @@ parsing, fallback, and cleanup without changing either source fixture. Rebuild
 them with `python tests/test_files/generate_pdf_cleanup_fixtures.py` in an
 environment with PyMuPDF installed; PyMuPDF is needed only to rebuild the files,
 not to run the core tests.
+
+The `rotated_plain_{btt,ttb}.pdf`, `rotated_mixed.pdf`, and `rotated_empty.pdf`
+fixtures exercise directional text extraction on plain, mixed, and empty pages.
+Rebuild them with
+`python tests/test_files/generate_rotated_pdf_fixtures.py` in an environment
+with ReportLab installed. ReportLab is needed only to rebuild the fixtures.
diff --git a/packages/markitdown/tests/test_files/generate_rotated_pdf_fixtures.py b/packages/markitdown/tests/test_files/generate_rotated_pdf_fixtures.py
new file mode 100644
index 0000000000..daa9eb0182
--- /dev/null
+++ b/packages/markitdown/tests/test_files/generate_rotated_pdf_fixtures.py
@@ -0,0 +1,50 @@
+from pathlib import Path
+
+from reportlab.pdfgen import canvas
+
+
+FIXTURES = Path(__file__).resolve().parent
+
+
+def draw_rotated_text(pdf: canvas.Canvas, direction: str) -> None:
+    pdf.drawString(50, 750, "Rotation example")
+    pdf.saveState()
+    pdf.translate(250, 400)
+    pdf.rotate(90 if direction == "btt" else -90)
+    pdf.drawString(0, 0, "Projected Population Kharif Rice")
+    pdf.restoreState()
+
+
+def main() -> None:
+    for direction in ("btt", "ttb"):
+        pdf = canvas.Canvas(
+            str(FIXTURES / f"rotated_plain_{direction}.pdf"), invariant=True
+        )
+        draw_rotated_text(pdf, direction)
+        pdf.save()
+
+    pdf = canvas.Canvas(str(FIXTURES / "rotated_mixed.pdf"), invariant=True)
+    draw_rotated_text(pdf, "btt")
+    pdf.showPage()
+    pdf.drawString(50, 780, "Inventory")
+    for y, row in zip(
+        (750, 730, 710),
+        (
+            ("Column A", "Column B", "Column C"),
+            ("Alpha", "100", "kg"),
+            ("Beta", "200", "lb"),
+        ),
+    ):
+        for x, value in zip((50, 250, 450), row):
+            pdf.drawString(x, y, value)
+    pdf.showPage()
+    draw_rotated_text(pdf, "btt")
+    pdf.save()
+
+    pdf = canvas.Canvas(str(FIXTURES / "rotated_empty.pdf"), invariant=True)
+    pdf.showPage()
+    pdf.save()
+
+
+if __name__ == "__main__":
+    main()
diff --git a/packages/markitdown/tests/test_files/rotated_empty.pdf b/packages/markitdown/tests/test_files/rotated_empty.pdf
new file mode 100644
index 0000000000..15bcd39e4c
Binary files /dev/null and b/packages/markitdown/tests/test_files/rotated_empty.pdf differ
diff --git a/packages/markitdown/tests/test_files/rotated_mixed.pdf b/packages/markitdown/tests/test_files/rotated_mixed.pdf
new file mode 100644
index 0000000000..9a37bd8bde
Binary files /dev/null and b/packages/markitdown/tests/test_files/rotated_mixed.pdf differ
diff --git a/packages/markitdown/tests/test_files/rotated_plain_btt.pdf b/packages/markitdown/tests/test_files/rotated_plain_btt.pdf
new file mode 100644
index 0000000000..84a1833347
Binary files /dev/null and b/packages/markitdown/tests/test_files/rotated_plain_btt.pdf differ
diff --git a/packages/markitdown/tests/test_files/rotated_plain_ttb.pdf b/packages/markitdown/tests/test_files/rotated_plain_ttb.pdf
new file mode 100644
index 0000000000..600ef139c3
Binary files /dev/null and b/packages/markitdown/tests/test_files/rotated_plain_ttb.pdf differ
diff --git a/packages/markitdown/tests/test_files/rotated_table.pdf b/packages/markitdown/tests/test_files/rotated_table.pdf
new file mode 100644
index 0000000000..5f3ed67d3e
Binary files /dev/null and b/packages/markitdown/tests/test_files/rotated_table.pdf differ
diff --git a/packages/markitdown/tests/test_pdf.py b/packages/markitdown/tests/test_pdf.py
index c4f8c64a9c..64f03210ea 100644
--- a/packages/markitdown/tests/test_pdf.py
+++ b/packages/markitdown/tests/test_pdf.py
@@ -6,9 +6,10 @@
 
 import pytest
 
-from markitdown import MarkItDown
+from markitdown import FileConversionException, MarkItDown, StreamInfo
 from markitdown.converters._pdf_converter import (
     PARTIAL_NUMBERING_PATTERN,
+    PdfConverter,
     _merge_partial_numbering_lines,
 )
 
@@ -1043,6 +1044,81 @@ def test_borderless_table_data_integrity(self, markitdown):
         assert "Electronics" in table_text, "Second table should contain Electronics"
         assert "Hardware" in table_text, "Second table should contain Hardware"
 
+    def test_rotated_text_direction_can_be_configured(self, markitdown):
+        """Test that bottom-to-top rotated text can use pdfplumber's direction option."""
+        pdf_path = os.path.join(TEST_FILES_DIR, "rotated_table.pdf")
+
+        default_result = markitdown.convert(pdf_path)
+        assert "noitalupoP" in default_result.text_content
+
+        result = markitdown.convert(pdf_path, pdf_char_dir_rotated="btt")
+        assert "Projected Population" in result.text_content
+        assert "noitalupoP" not in result.text_content
+        table = (
+            "| Column A | Column B | Column C |\n"
+            "| -------- | -------- | -------- |\n"
+            "| Alpha    | 100      | kg       |\n"
+            "| Beta     | 200      | lb       |"
+        )
+        assert table in default_result.text_content
+        assert table in result.text_content
+
+    @pytest.mark.parametrize("direction", ["btt", "ttb"])
+    def test_rotated_plain_text_direction(self, markitdown, direction):
+        pdf_path = os.path.join(TEST_FILES_DIR, f"rotated_plain_{direction}.pdf")
+        with open(pdf_path, "rb") as stream:
+            result = markitdown.convert_stream(
+                stream,
+                stream_info=StreamInfo(extension=".pdf"),
+                pdf_char_dir_rotated=direction,
+            )
+        assert result.text_content == (
+            "Rotation example\nProjected\nPopulation\nKharif\nRice"
+        )
+
+    def test_rotated_mixed_pages_preserve_order(self, markitdown):
+        pdf_path = os.path.join(TEST_FILES_DIR, "rotated_mixed.pdf")
+        result = markitdown.convert(pdf_path, pdf_char_dir_rotated="btt")
+        plain_page = "Rotation example\nProjected\nPopulation\nKharif\nRice"
+        table_page = (
+            "Inventory\n"
+            "| Column A | Column B | Column C |\n"
+            "| -------- | -------- | -------- |\n"
+            "| Alpha    | 100      | kg       |\n"
+            "| Beta     | 200      | lb       |"
+        )
+        assert result.text_content == "\n\n".join((plain_page, table_page, plain_page))
+
+    @pytest.mark.parametrize("direction", ["", "foo", "ltr", "rtl", True, 1, [], {}])
+    def test_invalid_rotated_direction_raises(self, markitdown, direction):
+        pdf_path = os.path.join(TEST_FILES_DIR, "rotated_table.pdf")
+        with open(pdf_path, "rb") as stream:
+            with pytest.raises(ValueError, match="pdf_char_dir_rotated"):
+                PdfConverter().convert(
+                    stream,
+                    StreamInfo(extension=".pdf"),
+                    pdf_char_dir_rotated=direction,
+                )
+            assert stream.tell() == 0
+        with pytest.raises(FileConversionException, match="pdf_char_dir_rotated"):
+            markitdown.convert(pdf_path, pdf_char_dir_rotated=direction)
+
+    @pytest.mark.parametrize("kind", ["plain", "form", "mixed"])
+    def test_unset_rotated_direction_preserves_default(self, markitdown, kind):
+        pdf_path = os.path.join(TEST_FILES_DIR, f"pdf_cleanup_{kind}.pdf")
+        default = markitdown.convert(pdf_path).text_content
+        assert default.strip()
+        assert (
+            markitdown.convert(pdf_path, pdf_char_dir_rotated=None).text_content
+            == default
+        )
+
+    @pytest.mark.parametrize("direction", ["btt", "ttb"])
+    def test_rotated_direction_with_empty_page(self, markitdown, direction):
+        pdf_path = os.path.join(TEST_FILES_DIR, "rotated_empty.pdf")
+        result = markitdown.convert(pdf_path, pdf_char_dir_rotated=direction)
+        assert result.text_content == ""
+
 
 # MasterFormat numbering