diff --git a/CHANGELOG.md b/CHANGELOG.md
index 09d48bbf0a5..5ffaae67518 100644
--- a/CHANGELOG.md
+++ b/CHANGELOG.md
@@ -40,6 +40,9 @@ release.
 
 ### Compatibility
 
+- Clarify expectations about Prometheus content negotiation for metric names.
+  ([#4543](https://github.com/open-telemetry/opentelemetry-specification/pull/4543))
+
 ### SDK Configuration
 
 ### Common
diff --git a/specification/metrics/sdk_exporters/prometheus.md b/specification/metrics/sdk_exporters/prometheus.md
index 1fc1936b6eb..1db6f264d6c 100644
--- a/specification/metrics/sdk_exporters/prometheus.md
+++ b/specification/metrics/sdk_exporters/prometheus.md
@@ -74,3 +74,9 @@ The option MAY be named `without_scope_info`, and MUST be `false` by default.
 
 A Prometheus Exporter MAY support a configuration option to produce metrics without a [target info](../../compatibility/prometheus_and_openmetrics.md#resource-attributes-1)
 metric. The option MAY be named `without_target_info`, and MUST be `false` by default.
+
+## Content Negotiation
+
+A Prometheus Exporter MUST support content negotiation to allow clients to request
+metrics in different formats based on the `Accept` header in HTTP requests. Content
+negotiation MUST follow [Prometheus Content Negotiation guidelines](https://prometheus.io/docs/instrumenting/content_negotiation/).