diff --git a/mypyc/irbuild/statement.py b/mypyc/irbuild/statement.py
index a797b8f5ab34..aac19cc8a75e 100644
--- a/mypyc/irbuild/statement.py
+++ b/mypyc/irbuild/statement.py
@@ -121,6 +121,7 @@
     keep_propagating_op,
     no_err_occurred_op,
     propagate_if_error_op,
+    raise_exception_from_op,
     raise_exception_op,
     reraise_exception_op,
     restore_exc_info_op,
@@ -679,7 +680,16 @@ def transform_raise_stmt(builder: IRBuilder, s: RaiseStmt) -> None:
         return
 
     exc = builder.accept(s.expr)
-    builder.call_c(raise_exception_op, [exc], s.line)
+    if s.from_expr is not None:
+        if isinstance(exc, Register):
+            # Evaluating the cause may reassign the variable holding the exception.
+            temp = Register(exc.type)
+            builder.assign(temp, exc, s.line)
+            exc = temp
+        cause = builder.accept(s.from_expr)
+        builder.call_c(raise_exception_from_op, [exc, cause], s.line)
+    else:
+        builder.call_c(raise_exception_op, [exc], s.line)
     builder.add(Unreachable())
 
 
diff --git a/mypyc/lib-rt/CPy.h b/mypyc/lib-rt/CPy.h
index 5500ebdd86e7..64cd25f0c335 100644
--- a/mypyc/lib-rt/CPy.h
+++ b/mypyc/lib-rt/CPy.h
@@ -979,6 +979,7 @@ static inline bool CPy_KeepPropagating(void) {
 #define CPy_ExcState() PyThreadState_GET()->exc_info
 
 void CPy_Raise(PyObject *exc);
+void CPy_RaiseFrom(PyObject *exc, PyObject *cause);
 void CPy_Reraise(void);
 void CPyErr_SetObjectAndTraceback(PyObject *type, PyObject *value, PyObject *traceback);
 tuple_T3OOO CPy_CatchError(void);
diff --git a/mypyc/lib-rt/exc_ops.c b/mypyc/lib-rt/exc_ops.c
index c2a220d280ee..f6a79fa8197a 100644
--- a/mypyc/lib-rt/exc_ops.c
+++ b/mypyc/lib-rt/exc_ops.c
@@ -7,16 +7,67 @@
 #include <Python.h>
 #include "CPy.h"
 
-void CPy_Raise(PyObject *exc) {
-    if (PyObject_IsInstance(exc, (PyObject *)&PyType_Type)) {
-        PyObject *obj = PyObject_CallNoArgs(exc);
-        if (!obj)
+// Return a new exception instance, or NULL with an error set.
+static PyObject *instantiate_exception(PyObject *type) {
+    PyObject *value = PyObject_CallNoArgs(type);
+    if (!value)
+        return NULL;
+    if (!PyExceptionInstance_Check(value)) {
+        PyErr_Format(PyExc_TypeError,
+                     "calling %R should have returned an instance of "
+                     "BaseException, not %R", type, Py_TYPE(value));
+        Py_DECREF(value);
+        return NULL;
+    }
+    return value;
+}
+
+// A NULL cause means no 'from' clause; Py_None means 'from None'.
+static void raise_exception(PyObject *exc, PyObject *cause) {
+    PyObject *type;
+    PyObject *value;
+    if (PyExceptionClass_Check(exc)) {
+        type = exc;
+        value = instantiate_exception(exc);
+        if (!value)
             return;
-        PyErr_SetObject(exc, obj);
-        Py_DECREF(obj);
+    } else if (PyExceptionInstance_Check(exc)) {
+        type = (PyObject *)Py_TYPE(exc);
+        value = Py_NewRef(exc);
     } else {
-        PyErr_SetObject((PyObject *)Py_TYPE(exc), exc);
+        PyErr_SetString(PyExc_TypeError, "exceptions must derive from BaseException");
+        return;
+    }
+
+    if (cause != NULL) {
+        PyObject *fixed_cause;
+        if (PyExceptionClass_Check(cause)) {
+            fixed_cause = instantiate_exception(cause);
+            if (!fixed_cause)
+                goto fail;
+        } else if (PyExceptionInstance_Check(cause)) {
+            fixed_cause = Py_NewRef(cause);
+        } else if (Py_IsNone(cause)) {
+            fixed_cause = NULL;
+        } else {
+            PyErr_SetString(PyExc_TypeError, "exception causes must derive from BaseException");
+            goto fail;
+        }
+        // This steals the reference to the cause and sets __suppress_context__
+        PyException_SetCause(value, fixed_cause);
     }
+    // Normalize against the original class, even if __new__ returned an unrelated exception.
+    PyErr_SetObject(type, value);
+fail:
+    Py_DECREF(value);
+}
+
+void CPy_Raise(PyObject *exc) {
+    raise_exception(exc, NULL);
+}
+
+void CPy_RaiseFrom(PyObject *exc, PyObject *cause) {
+    raise_exception(exc, cause);
 }
 
 void CPy_Reraise(void) {
diff --git a/mypyc/primitives/exc_ops.py b/mypyc/primitives/exc_ops.py
index e1234f807afa..528a89ef2331 100644
--- a/mypyc/primitives/exc_ops.py
+++ b/mypyc/primitives/exc_ops.py
@@ -15,6 +15,14 @@
     error_kind=ERR_ALWAYS,
 )
 
+# Like raise_exception_op, but also set the cause (raise <exc> from <cause>).
+raise_exception_from_op = custom_op(
+    arg_types=[object_rprimitive, object_rprimitive],
+    return_type=void_rtype,
+    c_function_name="CPy_RaiseFrom",
+    error_kind=ERR_ALWAYS,
+)
+
 # Raise StopIteration exception with the specified value (which can be NULL).
 set_stop_iteration_value = custom_op(
     arg_types=[object_rprimitive],
diff --git a/mypyc/test-data/fixtures/ir.py b/mypyc/test-data/fixtures/ir.py
index edb9318e2e39..708e9356d203 100644
--- a/mypyc/test-data/fixtures/ir.py
+++ b/mypyc/test-data/fixtures/ir.py
@@ -351,7 +351,10 @@ def fget(self) -> Any: ...
     def fset(self, value: Any) -> None: ...
     def fdel(self) -> None: ...
 
-class BaseException: pass
+class BaseException:
+    __cause__: Optional[BaseException]
+    __context__: Optional[BaseException]
+    __suppress_context__: bool
 
 class Exception(BaseException):
     def __init__(self, message: Optional[str] = None) -> None: pass
diff --git a/mypyc/test-data/run-exceptions.test b/mypyc/test-data/run-exceptions.test
index 1b180b933197..8257bfd9b894 100644
--- a/mypyc/test-data/run-exceptions.test
+++ b/mypyc/test-data/run-exceptions.test
@@ -532,3 +532,136 @@ Traceback (most recent call last):
   File "native.py", line 6, in <module>
     f(y)
 TypeError: int object expected; got str
+
+[case testRaiseFrom]
+from typing import Any
+
+from exceptions_helper import OtherException
+from testutil import assertRaises
+
+class Inner(Exception):
+    pass
+
+class Outer(Exception):
+    pass
+
+def raise_from(exc: Any, cause: Any) -> None:
+    try:
+        raise Inner("inner")
+    except Inner:
+        raise exc from cause
+
+def test_raise_from_instance() -> None:
+    cause = ValueError("cause")
+    try:
+        raise_from(Outer("outer"), cause)
+    except Outer as e:
+        assert e.__cause__ is cause
+        assert e.__suppress_context__
+        assert isinstance(e.__context__, Inner)
+    else:
+        assert False
+
+def test_raise_from_class() -> None:
+    try:
+        raise_from(Outer, ValueError)
+    except Outer as e:
+        assert type(e.__cause__) is ValueError
+        assert e.__suppress_context__
+    else:
+        assert False
+
+def test_raise_from_none() -> None:
+    try:
+        raise_from(Outer("outer"), None)
+    except Outer as e:
+        assert e.__cause__ is None
+        assert e.__suppress_context__
+        assert isinstance(e.__context__, Inner)
+    else:
+        assert False
+
+def test_raise_from_invalid_cause() -> None:
+    with assertRaises(TypeError, "exception causes must derive from BaseException"):
+        raise_from(Outer("outer"), 1)
+
+def test_raise_from_invalid_exception() -> None:
+    with assertRaises(TypeError, "exceptions must derive from BaseException"):
+        raise_from(1, ValueError())
+
+def test_raise_from_in_except() -> None:
+    try:
+        try:
+            raise Inner("inner")
+        except Inner as exc:
+            raise Outer("outer") from exc
+    except Outer as e:
+        assert isinstance(e.__cause__, Inner)
+        assert e.__cause__ is e.__context__
+    else:
+        assert False
+
+def test_raise_from_reassigned_exception() -> None:
+    original = ValueError("original")
+    cause = TypeError("cause")
+    exc: Exception = original
+    try:
+        raise exc from (exc := cause)
+    except ValueError as e:
+        assert e is original
+        assert e.__cause__ is cause
+        assert exc is cause
+    else:
+        assert False
+
+def test_raise_from_class_returning_unrelated_exception() -> None:
+    # Normalization calls OtherException again with the ValueError as an argument.
+    with assertRaises(TypeError):
+        raise_from(OtherException, None)
+
+def raise_plain(exc: Any) -> None:
+    raise exc
+
+def test_raise_plain_preserves_cause() -> None:
+    cause = ValueError("cause")
+    exc = Outer("outer")
+    try:
+        raise_from(exc, cause)
+    except Outer:
+        pass
+    try:
+        raise_plain(exc)
+    except Outer as e:
+        assert e is exc
+        assert e.__cause__ is cause
+        assert e.__suppress_context__
+    else:
+        assert False
+
+def test_raise_plain_does_not_suppress_context() -> None:
+    try:
+        try:
+            raise Inner("inner")
+        except Inner:
+            raise_plain(Outer("outer"))
+    except Outer as e:
+        assert e.__cause__ is None
+        assert not e.__suppress_context__
+        assert isinstance(e.__context__, Inner)
+    else:
+        assert False
+
+def test_raise_plain_invalid_exception() -> None:
+    with assertRaises(TypeError, "exceptions must derive from BaseException"):
+        raise_plain(1)
+
+def test_raise_plain_class_returning_unrelated_exception() -> None:
+    with assertRaises(TypeError):
+        raise_plain(OtherException)
+
+[file exceptions_helper.py]
+from typing import Any
+
+class OtherException(Exception):
+    def __new__(cls) -> Any:
+        return ValueError("other")