diff --git a/.vscode/launch.json b/.vscode/launch.json
index d83318d936..1b65dacf85 100644
--- a/.vscode/launch.json
+++ b/.vscode/launch.json
@@ -41,7 +41,9 @@
             "request": "launch",
             "runtimeExecutable": "${execPath}",
             "args": [
-                "--disable-extensions",
+                // Create a temp profile that has no extensions / user settings.
+                // This allows us to only have the C# extension + the dotnet runtime installer extension dependency.
+                "--profile-temp",
                 "--extensionDevelopmentPath=${workspaceRoot}",
                 "--extensionTestsPath=${workspaceRoot}/out/test/featureTests"
             ],
@@ -63,7 +65,9 @@
             "request": "launch",
             "runtimeExecutable": "${execPath}",
             "args": [
-                "--disable-extensions",
+                // Create a temp profile that has no extensions / user settings.
+                // This allows us to only have the C# extension + the dotnet runtime installer extension dependency.
+                "--profile-temp",
                 "${workspaceRoot}/test/integrationTests/testAssets/singleCsproj",
                 "--extensionDevelopmentPath=${workspaceRoot}",
                 "--extensionTestsPath=${workspaceRoot}/out/test/integrationTests"
@@ -78,7 +82,8 @@
             },
             "sourceMaps": true,
             "outFiles": [
-                "${workspaceRoot}/dist/*.js"
+                "${workspaceRoot}/dist/*.js",
+                "${workspaceRoot}/out/test/**/*.js"
             ],
             "preLaunchTask": "buildDev"
         },
@@ -88,7 +93,9 @@
             "request": "launch",
             "runtimeExecutable": "${execPath}",
             "args": [
-                "--disable-extensions",
+                // Create a temp profile that has no extensions / user settings.
+                // This allows us to only have the C# extension + the dotnet runtime installer extension dependency.
+                "--profile-temp",
                 "${workspaceRoot}/test/integrationTests/testAssets/BasicRazorApp2_1",
                 "--extensionDevelopmentPath=${workspaceRoot}",
                 "--extensionTestsPath=${workspaceRoot}/out/test/integrationTests"
@@ -108,7 +115,9 @@
             "request": "launch",
             "runtimeExecutable": "${execPath}",
             "args": [
-                "--disable-extensions",
+                // Create a temp profile that has no extensions / user settings.
+                // This allows us to only have the C# extension + the dotnet runtime installer extension dependency.
+                "--profile-temp",
                 "${workspaceRoot}/test/integrationTests/testAssets/slnWithCsproj",
                 "--extensionDevelopmentPath=${workspaceRoot}",
                 "--extensionTestsPath=${workspaceRoot}/out/test/integrationTests"
@@ -124,7 +133,8 @@
             "stopOnEntry": false,
             "sourceMaps": true,
             "outFiles": [
-                "${workspaceRoot}/dist/*.js"
+                "${workspaceRoot}/dist/*.js",
+                "${workspaceRoot}/out/test/**/*.js"
             ],
             "preLaunchTask": "buildDev"
         },
@@ -134,7 +144,9 @@
             "request": "launch",
             "runtimeExecutable": "${execPath}",
             "args": [
-                "--disable-extensions",
+                // Create a temp profile that has no extensions / user settings.
+                // This allows us to only have the C# extension + the dotnet runtime installer extension dependency.
+                "--profile-temp",
                 "${workspaceRoot}/test/integrationTests/testAssets/singleCsproj",
                 "--extensionDevelopmentPath=${workspaceRoot}",
                 "--extensionTestsPath=${workspaceRoot}/out/test/integrationTests"
@@ -150,7 +162,8 @@
             "stopOnEntry": false,
             "sourceMaps": true,
             "outFiles": [
-                "${workspaceRoot}/dist/*.js"
+                "${workspaceRoot}/dist/*.js",
+                "${workspaceRoot}/out/test/**/*.js"
             ],
             "preLaunchTask": "buildDev"
         },
@@ -160,7 +173,9 @@
             "request": "launch",
             "runtimeExecutable": "${execPath}",
             "args": [
-                "--disable-extensions",
+                // Create a temp profile that has no extensions / user settings.
+                // This allows us to only have the C# extension + the dotnet runtime installer extension dependency.
+                "--profile-temp",
                 "${workspaceRoot}/test/integrationTests/testAssets/BasicRazorApp2_1",
                 "--extensionDevelopmentPath=${workspaceRoot}",
                 "--extensionTestsPath=${workspaceRoot}/out/test/integrationTests"
@@ -180,7 +195,9 @@
             "request": "launch",
             "runtimeExecutable": "${execPath}",
             "args": [
-                "--disable-extensions",
+                // Create a temp profile that has no extensions / user settings.
+                // This allows us to only have the C# extension + the dotnet runtime installer extension dependency.
+                "--profile-temp",
                 "${workspaceRoot}/test/integrationTests/testAssets/slnWithCsproj",
                 "--extensionDevelopmentPath=${workspaceRoot}",
                 "--extensionTestsPath=${workspaceRoot}/out/test/integrationTests"
@@ -195,7 +212,8 @@
             },
             "sourceMaps": true,
             "outFiles": [
-                "${workspaceRoot}/dist/*.js"
+                "${workspaceRoot}/dist/*.js",
+                "${workspaceRoot}/out/test/**/*.js"
             ],
             "preLaunchTask": "buildDev"
         },
@@ -205,7 +223,9 @@
             "request": "launch",
             "runtimeExecutable": "${execPath}",
             "args": [
-                "--disable-extensions",
+                // Create a temp profile that has no extensions / user settings.
+                // This allows us to only have the C# extension + the dotnet runtime installer extension dependency.
+                "--profile-temp",
                 "${workspaceRoot}/test/integrationTests/testAssets/slnFilterWithCsproj",
                 "--extensionDevelopmentPath=${workspaceRoot}",
                 "--extensionTestsPath=${workspaceRoot}/out/test/integrationTests"
@@ -219,7 +239,8 @@
             },
             "sourceMaps": true,
             "outFiles": [
-                "${workspaceRoot}/dist/*.js"
+                "${workspaceRoot}/dist/*.js",
+                "${workspaceRoot}/out/test/**/*.js"
             ],
             "preLaunchTask": "buildDev"
         },
@@ -229,7 +250,9 @@
             "request": "launch",
             "runtimeExecutable": "${execPath}",
             "args": [
-                "--disable-extensions",
+                // Create a temp profile that has no extensions / user settings.
+                // This allows us to only have the C# extension + the dotnet runtime installer extension dependency.
+                "--profile-temp",
                 "${workspaceRoot}/test/integrationTests/testAssets/slnWithGenerator",
                 "--extensionDevelopmentPath=${workspaceRoot}",
                 "--extensionTestsPath=${workspaceRoot}/out/test/integrationTests"
@@ -243,7 +266,8 @@
             },
             "sourceMaps": true,
             "outFiles": [
-                "${workspaceRoot}/dist/*.js"
+                "${workspaceRoot}/dist/*.js",
+                "${workspaceRoot}/out/test/**/*.js"
             ],
             "preLaunchTask": "buildDev"
         },
diff --git a/test/integrationTests/integrationHelpers.ts b/test/integrationTests/integrationHelpers.ts
index 439d429357..f86464076c 100644
--- a/test/integrationTests/integrationHelpers.ts
+++ b/test/integrationTests/integrationHelpers.ts
@@ -16,6 +16,14 @@ export interface ActivationResult {
 }
 
 export async function activateCSharpExtension(): Promise<ActivationResult> {
+    // Ensure the dependent extension exists - when launching via F5 launch.json we can't install the extension prior to opening vscode.
+    const vscodeDotnetRuntimeExtensionId = "ms-dotnettools.vscode-dotnet-runtime";
+    let dotnetRuntimeExtension = vscode.extensions.getExtension<OmnisharpExtensionExports>(vscodeDotnetRuntimeExtensionId);
+    if (!dotnetRuntimeExtension) {
+        await vscode.commands.executeCommand("workbench.extensions.installExtension", vscodeDotnetRuntimeExtensionId);
+        await vscode.commands.executeCommand("workbench.action.reloadWindow");
+    }
+
     const configuration = vscode.workspace.getConfiguration();
     configuration.update('omnisharp.enableLspDriver', process.env.OMNISHARP_DRIVER === 'lsp' ? true : false);
     if (process.env.OMNISHARP_LOCATION) {