diff --git a/experimental/packages/opentelemetry-instrumentation/package.json b/experimental/packages/opentelemetry-instrumentation/package.json
index 5128a556f5c..3e93f74af2a 100644
--- a/experimental/packages/opentelemetry-instrumentation/package.json
+++ b/experimental/packages/opentelemetry-instrumentation/package.json
@@ -71,7 +71,7 @@
   },
   "dependencies": {
     "@opentelemetry/api-logs": "0.210.0",
-    "import-in-the-middle": "^2.0.0",
+    "import-in-the-middle": "^2.0.1",
     "require-in-the-middle": "^8.0.0"
   },
   "peerDependencies": {
diff --git a/experimental/packages/opentelemetry-instrumentation/src/platform/node/instrumentation.ts b/experimental/packages/opentelemetry-instrumentation/src/platform/node/instrumentation.ts
index 9633aa9dde7..0f6bcbf4ac7 100644
--- a/experimental/packages/opentelemetry-instrumentation/src/platform/node/instrumentation.ts
+++ b/experimental/packages/opentelemetry-instrumentation/src/platform/node/instrumentation.ts
@@ -220,12 +220,13 @@ export abstract class InstrumentationBase<
       }
       return exports;
     }
-    // internal file
+    // internal file or submodule export
     const files = module.files ?? [];
     const normalizedName = path.normalize(name);
+    const normalizedModuleName = path.normalize(module.name);
     const supportedFileInstrumentations = files.filter(
       f =>
-        f.name === normalizedName &&
+        (f.name === normalizedName || f.name === normalizedModuleName) &&
         isSupported(f.supportedVersions, version, module.includePrerelease)
     );
     return supportedFileInstrumentations.reduce<T>((patchedExports, file) => {
diff --git a/experimental/packages/opentelemetry-instrumentation/test/node/EsmSubmoduleInstrumentation.test.mjs b/experimental/packages/opentelemetry-instrumentation/test/node/EsmSubmoduleInstrumentation.test.mjs
new file mode 100644
index 00000000000..21a29d5bd34
--- /dev/null
+++ b/experimental/packages/opentelemetry-instrumentation/test/node/EsmSubmoduleInstrumentation.test.mjs
@@ -0,0 +1,110 @@
+/*
+ * Copyright The OpenTelemetry Authors
+ *
+ * Licensed under the Apache License, Version 2.0 (the "License");
+ * you may not use this file except in compliance with the License.
+ * You may obtain a copy of the License at
+ *
+ *      https://www.apache.org/licenses/LICENSE-2.0
+ *
+ * Unless required by applicable law or agreed to in writing, software
+ * distributed under the License is distributed on an "AS IS" BASIS,
+ * WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied.
+ * See the License for the specific language governing permissions and
+ * limitations under the License.
+ */
+
+import * as assert from 'assert';
+
+import {
+  InstrumentationBase,
+  InstrumentationNodeModuleDefinition,
+  InstrumentationNodeModuleFile,
+} from '../../build/src/index.js';
+
+class TestInstrumentationSimple extends InstrumentationBase {
+  constructor(config) {
+    super('test-esm-submodule-exports', '0.0.1', config);
+  }
+  init() {
+    return [
+      new InstrumentationNodeModuleDefinition(
+        '@opentelemetry/esm-submodule-exports',
+        ['*'],
+        moduleExports => {
+          moduleExports.propertyOnMainModule = 'modified string in main module';
+          return moduleExports;
+        },
+        moduleExports => {
+          return moduleExports;
+        },
+        [
+          new InstrumentationNodeModuleFile(
+            '@opentelemetry/esm-submodule-exports/src/index.js',
+            ['*'],
+            moduleExports => {
+            moduleExports.propertyOnMainModule = 'modified string in main module';
+            return moduleExports;
+
+            },
+            moduleExports => {
+              return moduleExports;
+            }
+          ),
+        ]
+      ),
+      new InstrumentationNodeModuleDefinition(
+        '@opentelemetry/esm-submodule-exports/sub',
+        ['*'],
+        moduleExports => {
+          moduleExports.propertyOnSubModule = 'modified string in sub module';
+          return moduleExports;
+        },
+        moduleExports => {
+          return moduleExports;
+        },
+        [
+          new InstrumentationNodeModuleFile(
+            '@opentelemetry/esm-submodule-exports/sub',
+            ['*'],
+            moduleExports => {
+              moduleExports.propertyOnSubModule = 'modified string in sub module';
+              return moduleExports;
+            },
+            moduleExports => {
+              return moduleExports;
+            }
+          ),
+        ]
+      )
+    ];
+  }
+}
+
+describe('instrumenting an esm scoped submodule package', function () {
+  it('should patch main module', async function () {
+    const instrumentation = new TestInstrumentationSimple({
+      enabled: false,
+    });
+    instrumentation.enable();
+
+    const {
+      propertyOnMainModule,
+    } = await import('@opentelemetry/esm-submodule-exports');
+
+    assert.strictEqual(propertyOnMainModule, 'modified string in main module');
+  });
+
+  it('should patch sub module', async function () {
+    const instrumentation = new TestInstrumentationSimple({
+      enabled: false,
+    });
+    instrumentation.enable();
+
+    const {
+      propertyOnSubModule,
+    } = await import('@opentelemetry/esm-submodule-exports/sub');
+
+    assert.strictEqual(propertyOnSubModule, 'modified string in sub module');
+  });
+});
diff --git a/experimental/packages/opentelemetry-instrumentation/test/node/node_modules/@opentelemetry/esm-submodule-exports/package.json b/experimental/packages/opentelemetry-instrumentation/test/node/node_modules/@opentelemetry/esm-submodule-exports/package.json
new file mode 100644
index 00000000000..b570aec5672
--- /dev/null
+++ b/experimental/packages/opentelemetry-instrumentation/test/node/node_modules/@opentelemetry/esm-submodule-exports/package.json
@@ -0,0 +1,9 @@
+{
+  "name": "@opentelemetry/esm-submodule-exports",
+  "version": "0.1.0",
+  "type": "module",
+  "exports": {
+    ".": "./src/index.js",
+    "./sub": "./src/sub.js"
+  }
+}
diff --git a/experimental/packages/opentelemetry-instrumentation/test/node/node_modules/@opentelemetry/esm-submodule-exports/src/index.js b/experimental/packages/opentelemetry-instrumentation/test/node/node_modules/@opentelemetry/esm-submodule-exports/src/index.js
new file mode 100644
index 00000000000..230ebee1c5a
--- /dev/null
+++ b/experimental/packages/opentelemetry-instrumentation/test/node/node_modules/@opentelemetry/esm-submodule-exports/src/index.js
@@ -0,0 +1,5 @@
+import { testString } from './internal.js'
+
+export const getString = () => "from index.js: " + testString;
+
+export const propertyOnMainModule = 'string in main module';
diff --git a/experimental/packages/opentelemetry-instrumentation/test/node/node_modules/@opentelemetry/esm-submodule-exports/src/internal.js b/experimental/packages/opentelemetry-instrumentation/test/node/node_modules/@opentelemetry/esm-submodule-exports/src/internal.js
new file mode 100644
index 00000000000..98760d4e99f
--- /dev/null
+++ b/experimental/packages/opentelemetry-instrumentation/test/node/node_modules/@opentelemetry/esm-submodule-exports/src/internal.js
@@ -0,0 +1 @@
+export const testString = "internal string";
diff --git a/experimental/packages/opentelemetry-instrumentation/test/node/node_modules/@opentelemetry/esm-submodule-exports/src/sub.js b/experimental/packages/opentelemetry-instrumentation/test/node/node_modules/@opentelemetry/esm-submodule-exports/src/sub.js
new file mode 100644
index 00000000000..e7f301efe17
--- /dev/null
+++ b/experimental/packages/opentelemetry-instrumentation/test/node/node_modules/@opentelemetry/esm-submodule-exports/src/sub.js
@@ -0,0 +1,5 @@
+import { testString } from "./internal.js";
+
+export const getString = () => `from /sub: ${testString}`;
+
+export const propertyOnSubModule = 'string in sub module';
diff --git a/package-lock.json b/package-lock.json
index 02b9a97ab16..9a42de4ac80 100644
--- a/package-lock.json
+++ b/package-lock.json
@@ -867,7 +867,7 @@
       "license": "Apache-2.0",
       "dependencies": {
         "@opentelemetry/api-logs": "0.210.0",
-        "import-in-the-middle": "^2.0.0",
+        "import-in-the-middle": "^2.0.1",
         "require-in-the-middle": "^8.0.0"
       },
       "devDependencies": {