diff --git a/.chloggen/owilliams_newconfig.yaml b/.chloggen/owilliams_newconfig.yaml
new file mode 100644
index 0000000000000..299ae292520d4
--- /dev/null
+++ b/.chloggen/owilliams_newconfig.yaml
@@ -0,0 +1,27 @@
+# Use this changelog template to create an entry for release notes.
+
+# One of 'breaking', 'deprecation', 'new_component', 'enhancement', 'bug_fix'
+change_type: bug_fix
+
+# The name of the component, or a single word describing the area of concern, (e.g. filelogreceiver)
+component: prometheusexporter, prometheusremotewriteexporter
+
+# A brief description of the change.  Surround your text with quotes ("") if it needs to start with a backtick (`).
+note: Connect pkg.translator.prometheus.PermissiveLabelSanitization with relevant logic.
+
+# Mandatory: One or more tracking issues related to the change. You can use the PR number here if no issue exists.
+issues: [43077]
+
+# (Optional) One or more lines of additional information to render under the primary note.
+# These lines will be padded with 2 spaces and then inserted directly into the document.
+# Use pipe (|) for multiline entries.
+subtext:
+
+# If your change doesn't affect end users or the exported elements of any package,
+# you should instead start your pull request title with [chore] or use the "Skip Changelog" label.
+# Optional: The change log or logs in which this entry should be included.
+# e.g. '[user]' or '[user, api]'
+# Include 'user' if the change is relevant to end users.
+# Include 'api' if there is a change to a library API.
+# Default: '[user]'
+change_logs: []
diff --git a/exporter/prometheusexporter/README.md b/exporter/prometheusexporter/README.md
index 5e26aeabc225e..06c4ec9cdfa68 100644
--- a/exporter/prometheusexporter/README.md
+++ b/exporter/prometheusexporter/README.md
@@ -64,6 +64,10 @@ exporters:
 
 Given the example, metrics will be available at `https://1.2.3.4:1234/metrics`.
 
+### Feature gates
+
+There are also flags that control translation behavior. [See the documentation for the Prometheus translator module](../../pkg/translator/prometheus/) for more information.
+
 ## Metric names and labels normalization
 
 By Default, OpenTelemetry metric names and attributes are normalized to be compliant with [Prometheus naming rules](https://prometheus.io/docs/practices/naming/).
@@ -103,4 +107,4 @@ After this, grouping or selecting becomes as simple as:
 app_ads_ad_requests_total{namespace="my-namespace"}
 
 sum by (namespace) (app_ads_ad_requests_total)
-```
\ No newline at end of file
+```
diff --git a/exporter/prometheusexporter/collector.go b/exporter/prometheusexporter/collector.go
index d7034a52b4a0d..7943da5639c4b 100644
--- a/exporter/prometheusexporter/collector.go
+++ b/exporter/prometheusexporter/collector.go
@@ -92,7 +92,8 @@ func configureMetricNamer(config *Config) otlptranslator.MetricNamer {
 func configureLabelNamer(config *Config) otlptranslator.LabelNamer {
 	_, utf8Allowed := getTranslationConfiguration(config)
 	return otlptranslator.LabelNamer{
-		UTF8Allowed: utf8Allowed,
+		UTF8Allowed:                 utf8Allowed,
+		PreserveMultipleUnderscores: !prometheustranslator.DropSanitizationGate.IsEnabled(),
 	}
 }
 
diff --git a/exporter/prometheusremotewriteexporter/exporter.go b/exporter/prometheusremotewriteexporter/exporter.go
index c1f8fc6eee3f9..74253d97ce045 100644
--- a/exporter/prometheusremotewriteexporter/exporter.go
+++ b/exporter/prometheusremotewriteexporter/exporter.go
@@ -33,6 +33,7 @@ import (
 	"go.uber.org/zap"
 
 	"github.com/open-telemetry/opentelemetry-collector-contrib/exporter/prometheusremotewriteexporter/internal/metadata"
+	prometheustranslator "github.com/open-telemetry/opentelemetry-collector-contrib/pkg/translator/prometheus"
 	"github.com/open-telemetry/opentelemetry-collector-contrib/pkg/translator/prometheusremotewrite"
 )
 
@@ -305,7 +306,9 @@ func (prwe *prwExporter) PushMetrics(ctx context.Context, md pmetric.Metrics) er
 }
 
 func validateAndSanitizeExternalLabels(cfg *Config) (map[string]string, error) {
-	namer := otlptranslator.LabelNamer{}
+	namer := otlptranslator.LabelNamer{
+		UnderscoreLabelSanitization: !prometheustranslator.DropSanitizationGate.IsEnabled(),
+	}
 	sanitizedLabels := make(map[string]string)
 	for key, value := range cfg.ExternalLabels {
 		if key == "" || value == "" {
diff --git a/exporter/prometheusremotewriteexporter/go.mod b/exporter/prometheusremotewriteexporter/go.mod
index d3310170b9d1d..fe1bb542aaf63 100644
--- a/exporter/prometheusremotewriteexporter/go.mod
+++ b/exporter/prometheusremotewriteexporter/go.mod
@@ -9,6 +9,7 @@ require (
 	github.com/open-telemetry/opentelemetry-collector-contrib/internal/common v0.136.0
 	github.com/open-telemetry/opentelemetry-collector-contrib/internal/coreinternal v0.136.0
 	github.com/open-telemetry/opentelemetry-collector-contrib/pkg/resourcetotelemetry v0.136.0
+	github.com/open-telemetry/opentelemetry-collector-contrib/pkg/translator/prometheus v0.136.0
 	github.com/open-telemetry/opentelemetry-collector-contrib/pkg/translator/prometheusremotewrite v0.136.0
 	github.com/prometheus/otlptranslator v1.0.0
 	github.com/prometheus/prometheus v0.305.1-0.20250808193045-294f36e80261
@@ -93,7 +94,6 @@ require (
 	github.com/modern-go/reflect2 v1.0.3-0.20250322232337-35a7c28c31ee // indirect
 	github.com/munnerz/goautoneg v0.0.0-20191010083416-a7dc8b61c822 // indirect
 	github.com/mwitkow/go-conntrack v0.0.0-20190716064945-2f068394615f // indirect
-	github.com/open-telemetry/opentelemetry-collector-contrib/pkg/translator/prometheus v0.136.0 // indirect
 	github.com/pierrec/lz4/v4 v4.1.22 // indirect
 	github.com/pkg/browser v0.0.0-20240102092130-5ac0b6a4141c // indirect
 	github.com/pmezard/go-difflib v1.0.1-0.20181226105442-5d4384ee4fb2 // indirect
diff --git a/pkg/translator/prometheus/README.md b/pkg/translator/prometheus/README.md
index 4e9b0d77cd58e..110ffbb43137e 100644
--- a/pkg/translator/prometheus/README.md
+++ b/pkg/translator/prometheus/README.md
@@ -13,7 +13,7 @@
 | Case                                                     | Transformation                                                                                                                   | Example                                                                                   |
 |----------------------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------|
 | Unsupported characters and extraneous underscores        | Replace unsupported characters with underscores (`_`). Drop redundant, leading and trailing underscores.                         | `(lambda).function.executions(#)` → `lambda_function_executions`                          |
-| Standard unit                                            | Convert the unit from [Unified Code for Units of Measure](http://unitsofmeasure.org/ucum.html) to Prometheus standard and append | `system.filesystem.usage` with unit `By` → `system_filesystem_usage_bytes`                |
+| Standard unit                                            | Convert the unit from [Unified Code for Units of Measure](http://ucum.org/ucum/) to Prometheus standard and append | `system.filesystem.usage` with unit `By` → `system_filesystem_usage_bytes`                |
 | Non-standard unit (unit is surrounded with `{}`)         | Drop the unit                                                                                                                    | `system.network.dropped` with unit `{packets}` → `system_network_dropped`                 |
 | Non-standard unit (unit is **not** surrounded with `{}`) | Append the unit, if not already present, after sanitization (all non-alphanumeric chars are dropped)                             | `system.network.dropped` with unit `packets` → `system_network_dropped_packets`           |
 | Percentages (unit is `1`)                                | Append `_ratio` (for gauges only)                                                                                                | `system.memory.utilization` with unit `1` → `system_memory_utilization_ratio`             |
@@ -82,7 +82,7 @@ OpenTelemetry *Attributes* are converted to Prometheus labels and normalized to
 The following transformations are performed on OpenTelemetry *Attributes* to produce Prometheus labels:
 
 * Drop unsupported characters and replace with underscores (`_`)
-* Prefix label with `key_` if it doesn't start with a letter, except if it's already prefixed with double-underscore (`__`)
+* Prefix label with `key_` if it doesn't start with a letter, except if it's already prefixed with double-underscore (`__`). This is to provide compatibility with OpenMetrics 1.0.
 
 By default, labels that start with a simple underscore (`_`) are prefixed with `key`, which is strictly unnecessary to follow Prometheus labels naming rules. This behavior can be disabled with the feature `pkg.translator.prometheus.PermissiveLabelSanitization`, which must be activated with the feature gate option of the collector:
 
diff --git a/pkg/translator/prometheus/normalize_label.go b/pkg/translator/prometheus/normalize_label.go
index 12e45e7f775ec..9ca6d0db0332d 100644
--- a/pkg/translator/prometheus/normalize_label.go
+++ b/pkg/translator/prometheus/normalize_label.go
@@ -10,7 +10,7 @@ import (
 	"go.opentelemetry.io/collector/featuregate"
 )
 
-var dropSanitizationGate = featuregate.GlobalRegistry().MustRegister(
+var DropSanitizationGate = featuregate.GlobalRegistry().MustRegister(
 	"pkg.translator.prometheus.PermissiveLabelSanitization",
 	featuregate.StageAlpha,
 	featuregate.WithRegisterDescription("Controls whether to change labels starting with '_' to 'key_'."),
@@ -36,7 +36,7 @@ func NormalizeLabel(label string) string {
 	// If label starts with a number, prepend with "key_"
 	if unicode.IsDigit(rune(label[0])) {
 		label = "key_" + label
-	} else if strings.HasPrefix(label, "_") && !strings.HasPrefix(label, "__") && !dropSanitizationGate.IsEnabled() {
+	} else if strings.HasPrefix(label, "_") && !strings.HasPrefix(label, "__") && !DropSanitizationGate.IsEnabled() {
 		label = "key" + label
 	}
 
diff --git a/pkg/translator/prometheus/normalize_label_test.go b/pkg/translator/prometheus/normalize_label_test.go
index 84578614d0eae..75771c4a0f3ae 100644
--- a/pkg/translator/prometheus/normalize_label_test.go
+++ b/pkg/translator/prometheus/normalize_label_test.go
@@ -12,7 +12,7 @@ import (
 )
 
 func TestSanitize(t *testing.T) {
-	defer testutil.SetFeatureGateForTest(t, dropSanitizationGate, false)()
+	defer testutil.SetFeatureGateForTest(t, DropSanitizationGate, false)()
 
 	require.Empty(t, NormalizeLabel(""))
 	require.Equal(t, "key_test", NormalizeLabel("_test"))
@@ -23,7 +23,7 @@ func TestSanitize(t *testing.T) {
 }
 
 func TestSanitizeDropSanitization(t *testing.T) {
-	defer testutil.SetFeatureGateForTest(t, dropSanitizationGate, true)()
+	defer testutil.SetFeatureGateForTest(t, DropSanitizationGate, true)()
 
 	require.Empty(t, NormalizeLabel(""))
 	require.Equal(t, "_test", NormalizeLabel("_test"))
diff --git a/pkg/translator/prometheusremotewrite/helper.go b/pkg/translator/prometheusremotewrite/helper.go
index e489eda50698b..f5b520cda64f5 100644
--- a/pkg/translator/prometheusremotewrite/helper.go
+++ b/pkg/translator/prometheusremotewrite/helper.go
@@ -24,6 +24,8 @@ import (
 	"go.opentelemetry.io/collector/pdata/pmetric"
 	conventions "go.opentelemetry.io/otel/semconv/v1.25.0"
 	"go.uber.org/multierr"
+
+	prometheustranslator "github.com/open-telemetry/opentelemetry-collector-contrib/pkg/translator/prometheus"
 )
 
 const (
@@ -529,7 +531,7 @@ func addResourceTargetInfo(resource pcommon.Resource, settings Settings, timesta
 		name = settings.Namespace + "_" + name
 	}
 
-	labels, err := createAttributes(resource, attributes, settings.ExternalLabels, identifyingAttrs, false, otlptranslator.LabelNamer{}, model.MetricNameLabel, name)
+	labels, err := createAttributes(resource, attributes, settings.ExternalLabels, identifyingAttrs, false, otlptranslator.LabelNamer{PreserveMultipleUnderscores: !prometheustranslator.DropSanitizationGate.IsEnabled()}, model.MetricNameLabel, name)
 	if err != nil {
 		return err
 	}
diff --git a/pkg/translator/prometheusremotewrite/helper_test.go b/pkg/translator/prometheusremotewrite/helper_test.go
index 61b2b6d3ff81a..6319ba54a66fb 100644
--- a/pkg/translator/prometheusremotewrite/helper_test.go
+++ b/pkg/translator/prometheusremotewrite/helper_test.go
@@ -244,13 +244,14 @@ func Test_timeSeriesSignature(t *testing.T) {
 // collision happens. It does not check whether labels are not sorted
 func Test_createLabelSet(t *testing.T) {
 	tests := []struct {
-		name           string
-		resource       pcommon.Resource
-		orig           pcommon.Map
-		externalLabels map[string]string
-		extras         []string
-		want           []prompb.Label
-		expectErr      bool
+		name                        string
+		resource                    pcommon.Resource
+		orig                        pcommon.Map
+		externalLabels              map[string]string
+		extras                      []string
+		want                        []prompb.Label
+		expectErr                   bool
+		underscoreLabelSanitization bool
 	}{
 		{
 			name:           "labels_clean",
@@ -302,6 +303,15 @@ func Test_createLabelSet(t *testing.T) {
 			extras:         []string{label31 + dirty1, value31, label32, value32},
 			want:           getPromLabels(label11+"_", value11, "_"+label12, value12, label31+"_", value31, label32, value32),
 		},
+		{
+			name:                        "labels_dirty_with_sanitization",
+			resource:                    pcommon.NewResource(),
+			orig:                        lbs1Dirty,
+			externalLabels:              map[string]string{},
+			extras:                      []string{label31 + dirty1, value31, label32, value32},
+			want:                        getPromLabels(label11+"_", value11, "key_"+label12, value12, label31+"_", value31, label32, value32),
+			underscoreLabelSanitization: true,
+		},
 		{
 			name:           "no_original_case",
 			resource:       pcommon.NewResource(),
@@ -367,11 +377,22 @@ func Test_createLabelSet(t *testing.T) {
 			extras:         []string{label31, value31, label32, value32},
 			want:           getPromLabels(label11, value11, label12, value12, label51, value51, label41, value41, label31, value31, label32, value32),
 		},
+		{
+			name:                        "sanitize_labels_starts_with_underscore_with_sanitization",
+			resource:                    pcommon.NewResource(),
+			orig:                        lbs3,
+			externalLabels:              exlbs1,
+			extras:                      []string{label31, value31, label32, value32},
+			want:                        getPromLabels(label11, value11, label12, value12, "key"+label51, value51, label41, value41, label31, value31, label32, value32),
+			underscoreLabelSanitization: true,
+		},
 	}
-	// run tests
 	for _, tt := range tests {
 		t.Run(tt.name, func(t *testing.T) {
-			got, err := createAttributes(tt.resource, tt.orig, tt.externalLabels, nil, true, otlptranslator.LabelNamer{}, tt.extras...)
+			labelNamer := otlptranslator.LabelNamer{
+				UnderscoreLabelSanitization: tt.underscoreLabelSanitization,
+			}
+			got, err := createAttributes(tt.resource, tt.orig, tt.externalLabels, nil, true, labelNamer, tt.extras...)
 			if tt.expectErr {
 				require.Error(t, err)
 				return
diff --git a/pkg/translator/prometheusremotewrite/metrics_to_prw.go b/pkg/translator/prometheusremotewrite/metrics_to_prw.go
index 43bf1cfe7fce4..49798afb1409b 100644
--- a/pkg/translator/prometheusremotewrite/metrics_to_prw.go
+++ b/pkg/translator/prometheusremotewrite/metrics_to_prw.go
@@ -15,6 +15,8 @@ import (
 	"go.opentelemetry.io/collector/pdata/pcommon"
 	"go.opentelemetry.io/collector/pdata/pmetric"
 	"go.uber.org/multierr"
+
+	"github.com/open-telemetry/opentelemetry-collector-contrib/pkg/translator/prometheus"
 )
 
 type Settings struct {
@@ -53,7 +55,7 @@ func newPrometheusConverter(settings Settings) *prometheusConverter {
 		unique:      map[uint64]*prompb.TimeSeries{},
 		conflicts:   map[uint64][]*prompb.TimeSeries{},
 		metricNamer: otlptranslator.MetricNamer{WithMetricSuffixes: settings.AddMetricSuffixes, Namespace: settings.Namespace},
-		labelNamer:  otlptranslator.LabelNamer{},
+		labelNamer:  otlptranslator.LabelNamer{UnderscoreLabelSanitization: !prometheus.DropSanitizationGate.IsEnabled()},
 		unitNamer:   otlptranslator.UnitNamer{},
 	}
 }
diff --git a/pkg/translator/prometheusremotewrite/metrics_to_prw_v2.go b/pkg/translator/prometheusremotewrite/metrics_to_prw_v2.go
index 3dffe1a9dced8..9532e907cb802 100644
--- a/pkg/translator/prometheusremotewrite/metrics_to_prw_v2.go
+++ b/pkg/translator/prometheusremotewrite/metrics_to_prw_v2.go
@@ -15,6 +15,8 @@ import (
 	"go.opentelemetry.io/collector/pdata/pcommon"
 	"go.opentelemetry.io/collector/pdata/pmetric"
 	"go.uber.org/multierr"
+
+	"github.com/open-telemetry/opentelemetry-collector-contrib/pkg/translator/prometheus"
 )
 
 // FromMetricsV2 converts pmetric.Metrics to Prometheus remote write format 2.0.
@@ -57,7 +59,7 @@ func newPrometheusConverterV2(settings Settings) *prometheusConverterV2 {
 		conflicts:   map[uint64][]*writev2.TimeSeries{},
 		symbolTable: writev2.NewSymbolTable(),
 		metricNamer: otlptranslator.MetricNamer{WithMetricSuffixes: settings.AddMetricSuffixes, Namespace: settings.Namespace},
-		labelNamer:  otlptranslator.LabelNamer{},
+		labelNamer:  otlptranslator.LabelNamer{UnderscoreLabelSanitization: !prometheus.DropSanitizationGate.IsEnabled()},
 		unitNamer:   otlptranslator.UnitNamer{},
 	}
 }