diff --git a/experimental/CHANGELOG.md b/experimental/CHANGELOG.md
index d025c4d4b7..7d5a24082a 100644
--- a/experimental/CHANGELOG.md
+++ b/experimental/CHANGELOG.md
@@ -12,6 +12,7 @@ All notable changes to experimental packages in this project will be documented
 
 * feat: use HTTP_ROUTE in span name [#3603](https://github.com/open-telemetry/opentelemetry-js/pull/3603) @Flarna
 * feat: add HTTP_ROUTE attribute to http incoming metrics if present [#3581](https://github.com/open-telemetry/opentelemetry-js/pull/3581) @hermogenes
+* feat(opentelemetry-instrumentation-grpc): allow to add attributes from grpc metadata in the patched server [#3589](https://github.com/open-telemetry/opentelemetry-js/pull/3589) @zombispormedio
 * feat(sdk-node): install diag logger with OTEL_LOG_LEVEL [#3627](https://github.com/open-telemetry/opentelemetry-js/pull/3627) @legendecas
 * feat(otlp-exporter-base): add retries [#3207](https://github.com/open-telemetry/opentelemetry-js/pull/3207) @svetlanabrennan
 * feat(sdk-node): override IdGenerator when using NodeSDK [#3645](https://github.com/open-telemetry/opentelemetry-js/pull/3645) @haddasbronfman
diff --git a/experimental/packages/opentelemetry-instrumentation-grpc/README.md b/experimental/packages/opentelemetry-instrumentation-grpc/README.md
index 0ea8330438..2aa6038c03 100644
--- a/experimental/packages/opentelemetry-instrumentation-grpc/README.md
+++ b/experimental/packages/opentelemetry-instrumentation-grpc/README.md
@@ -47,7 +47,7 @@ gRPC instrumentation accepts the following configuration:
 | Options                                                                                                                                                              | Type              | Description                                                                                                                                                                                                                                                               |
 |----------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
 | [`ignoreGrpcMethods`](https://github.com/open-telemetry/opentelemetry-js/blob/main/experimental/packages/opentelemetry-instrumentation-grpc/src/types.ts#L25)        | `IgnoreMatcher[]` | gRPC instrumentation will not trace any methods that match anything in this list. You may pass a string (case-insensitive match), a `RegExp` object, or a filter function.                                                                                                |
-| [`metadataToSpanAttributes`](https://github.com/open-telemetry/opentelemetry-js/blob/main/experimental/packages/opentelemetry-instrumentation-grpc/src/types.ts#L27) | `object`          | List of case insensitive metadata to convert to span attributes. Client (outgoing requests, incoming responses) metadata attributes will be converted to span attributes in the form of `rpc.{request\response}.metadata.metadata_key`, e.g. `rpc.response.metadata.date` |
+| [`metadataToSpanAttributes`](https://github.com/open-telemetry/opentelemetry-js/blob/main/experimental/packages/opentelemetry-instrumentation-grpc/src/types.ts#L27) | `object`          | List of case insensitive metadata to convert to span attributes. Client and server (outgoing requests, incoming responses) metadata attributes will be converted to span attributes in the form of `rpc.{request\response}.metadata.metadata_key`, e.g. `rpc.response.metadata.date` |
 
 ## Useful links
 
diff --git a/experimental/packages/opentelemetry-instrumentation-grpc/src/grpc-js/index.ts b/experimental/packages/opentelemetry-instrumentation-grpc/src/grpc-js/index.ts
index 2e5c833b19..6608521bd6 100644
--- a/experimental/packages/opentelemetry-instrumentation-grpc/src/grpc-js/index.ts
+++ b/experimental/packages/opentelemetry-instrumentation-grpc/src/grpc-js/index.ts
@@ -212,6 +212,24 @@ export class GrpcJsInstrumentation extends InstrumentationBase {
                       [SemanticAttributes.RPC_SERVICE]: service,
                     });
 
+                  instrumentation._metadataCapture.server.captureRequestMetadata(
+                    span,
+                    call.metadata
+                  );
+
+                  instrumentation._wrap(
+                    call,
+                    'sendMetadata',
+                    originalSendMetadata =>
+                      (responseMetadata: grpcJs.Metadata) => {
+                        instrumentation._metadataCapture.server.captureResponseMetadata(
+                          span,
+                          responseMetadata
+                        );
+                        originalSendMetadata.call(call, responseMetadata);
+                      }
+                  );
+
                   context.with(trace.setSpan(context.active(), span), () => {
                     handleServerFunction.call(
                       self,
@@ -385,6 +403,16 @@ export class GrpcJsInstrumentation extends InstrumentationBase {
           config.metadataToSpanAttributes?.client?.responseMetadata ?? []
         ),
       },
+      server: {
+        captureRequestMetadata: metadataCapture(
+          'request',
+          config.metadataToSpanAttributes?.server?.requestMetadata ?? []
+        ),
+        captureResponseMetadata: metadataCapture(
+          'response',
+          config.metadataToSpanAttributes?.server?.responseMetadata ?? []
+        ),
+      },
     };
   }
 }
diff --git a/experimental/packages/opentelemetry-instrumentation-grpc/src/grpc/index.ts b/experimental/packages/opentelemetry-instrumentation-grpc/src/grpc/index.ts
index 4df381eb66..fbeac0395e 100644
--- a/experimental/packages/opentelemetry-instrumentation-grpc/src/grpc/index.ts
+++ b/experimental/packages/opentelemetry-instrumentation-grpc/src/grpc/index.ts
@@ -223,6 +223,24 @@ export class GrpcNativeInstrumentation extends InstrumentationBase<
                       [SemanticAttributes.RPC_SERVICE]: service,
                     });
 
+                  instrumentation._metadataCapture.server.captureRequestMetadata(
+                    span,
+                    call.metadata
+                  );
+
+                  instrumentation._wrap(
+                    call as any,
+                    'sendMetadata',
+                    originalSendMetadata =>
+                      (responseMetadata: grpcTypes.Metadata) => {
+                        instrumentation._metadataCapture.server.captureResponseMetadata(
+                          span,
+                          responseMetadata
+                        );
+                        originalSendMetadata.call(call, responseMetadata);
+                      }
+                  );
+
                   context.with(trace.setSpan(context.active(), span), () => {
                     switch (type) {
                       case 'unary':
@@ -370,6 +388,16 @@ export class GrpcNativeInstrumentation extends InstrumentationBase<
           config.metadataToSpanAttributes?.client?.responseMetadata ?? []
         ),
       },
+      server: {
+        captureRequestMetadata: metadataCapture(
+          'request',
+          config.metadataToSpanAttributes?.server?.requestMetadata ?? []
+        ),
+        captureResponseMetadata: metadataCapture(
+          'response',
+          config.metadataToSpanAttributes?.server?.responseMetadata ?? []
+        ),
+      },
     };
   }
 }
diff --git a/experimental/packages/opentelemetry-instrumentation-grpc/src/internal-types.ts b/experimental/packages/opentelemetry-instrumentation-grpc/src/internal-types.ts
index d0052f7643..ebc17ae1d4 100644
--- a/experimental/packages/opentelemetry-instrumentation-grpc/src/internal-types.ts
+++ b/experimental/packages/opentelemetry-instrumentation-grpc/src/internal-types.ts
@@ -29,4 +29,14 @@ export type metadataCaptureType = {
       metadata: grpcJsTypes.Metadata | grpcTypes.Metadata
     ) => void;
   };
+  server: {
+    captureRequestMetadata: (
+      span: Span,
+      metadata: grpcJsTypes.Metadata | grpcTypes.Metadata
+    ) => void;
+    captureResponseMetadata: (
+      span: Span,
+      metadata: grpcJsTypes.Metadata | grpcTypes.Metadata
+    ) => void;
+  };
 };
diff --git a/experimental/packages/opentelemetry-instrumentation-grpc/src/types.ts b/experimental/packages/opentelemetry-instrumentation-grpc/src/types.ts
index dd08d8224b..430476b7a4 100644
--- a/experimental/packages/opentelemetry-instrumentation-grpc/src/types.ts
+++ b/experimental/packages/opentelemetry-instrumentation-grpc/src/types.ts
@@ -29,5 +29,9 @@ export interface GrpcInstrumentationConfig extends InstrumentationConfig {
       responseMetadata?: string[];
       requestMetadata?: string[];
     };
+    server?: {
+      responseMetadata?: string[];
+      requestMetadata?: string[];
+    };
   };
 }
diff --git a/experimental/packages/opentelemetry-instrumentation-grpc/test/helper.ts b/experimental/packages/opentelemetry-instrumentation-grpc/test/helper.ts
index 85b6a1c64e..58855a6a5f 100644
--- a/experimental/packages/opentelemetry-instrumentation-grpc/test/helper.ts
+++ b/experimental/packages/opentelemetry-instrumentation-grpc/test/helper.ts
@@ -978,6 +978,10 @@ export const runTests = (
               requestMetadata: ['client_metadata_key'],
               responseMetadata: ['server_metadata_key'],
             },
+            server: {
+              requestMetadata: ['client_metadata_key'],
+              responseMetadata: ['server_metadata_key'],
+            },
           },
         });
 
@@ -999,13 +1003,18 @@ export const runTests = (
         });
       });
 
-      describe('Capture request/response metadata in client span', () => {
+      describe('Capture request/response metadata in client and server spans', () => {
         const attributeValidation = {
           clientAttributes: {
             'rpc.request.metadata.client_metadata_key': 'client_metadata_value',
             'rpc.response.metadata.server_metadata_key':
               'server_metadata_value',
           },
+          serverAttributes: {
+            'rpc.request.metadata.client_metadata_key': 'client_metadata_value',
+            'rpc.response.metadata.server_metadata_key':
+              'server_metadata_value',
+          },
         };
 
         runTestWithAttributeValidation(