diff --git a/docs/rules/Moq1100.md b/docs/rules/Moq1100.md
index 369b351aa..f4fc513e6 100644
--- a/docs/rules/Moq1100.md
+++ b/docs/rules/Moq1100.md
@@ -70,6 +70,43 @@ var mock = new Mock<IMyService>()
     .Callback(new DoCallback((int i, string s, DateTime dt) => { }));
 ```
 
+## Advanced Patterns Supported
+
+This analyzer supports comprehensive validation of advanced callback patterns:
+
+### Multiple Callback Timing
+
+```csharp
+mock.Setup(x => x.DoWork("test"))
+    .Callback(() => Console.WriteLine("Before"))
+    .Returns(42)
+    .Callback(() => Console.WriteLine("After"));
+```
+
+### Ref/Out Parameter Callbacks
+
+```csharp
+delegate void ProcessDataCallback(ref string data);
+mock.Setup(x => x.ProcessData(ref It.Ref<string>.IsAny))
+    .Callback(new ProcessDataCallback((ref string data) => data = "processed"));
+```
+
+### Complex Multi-Parameter Scenarios
+
+```csharp
+mock.Setup(x => x.ProcessMultiple(It.IsAny<int>(), It.IsAny<string>(), It.IsAny<DateTime>()))
+    .Callback((int id, string name, DateTime timestamp) => Console.WriteLine($"Processing {id}"));
+```
+
+### Out Parameter Delegates
+
+```csharp
+delegate bool TryProcessCallback(out int result);
+mock.Setup(x => x.TryProcess(out It.Ref<int>.IsAny))
+    .Callback(new TryProcessCallback((out int result) => { result = 42; }))
+    .Returns(true);
+```
+
 ## Suppress a warning
 
 If you just want to suppress a single violation, add preprocessor directives to
diff --git a/tests/Moq.Analyzers.Test/CallbackSignatureShouldMatchMockedMethodAnalyzerTests.cs b/tests/Moq.Analyzers.Test/CallbackSignatureShouldMatchMockedMethodAnalyzerTests.cs
new file mode 100644
index 000000000..f77fa314c
--- /dev/null
+++ b/tests/Moq.Analyzers.Test/CallbackSignatureShouldMatchMockedMethodAnalyzerTests.cs
@@ -0,0 +1,127 @@
+using Moq.Analyzers.Test.Helpers;
+
+using AnalyzerVerifier = Moq.Analyzers.Test.Helpers.AnalyzerVerifier<Moq.Analyzers.CallbackSignatureShouldMatchMockedMethodAnalyzer>;
+
+namespace Moq.Analyzers.Test;
+
+/// <summary>
+/// Comprehensive tests for the CallbackSignatureShouldMatchMockedMethodAnalyzer.
+/// Validates all advanced callback patterns including ref/out parameters, multiple callbacks,
+/// generic callbacks, and complex scenarios from issue #434.
+/// </summary>
+public class CallbackSignatureShouldMatchMockedMethodAnalyzerTests(ITestOutputHelper output)
+{
+    /// <summary>
+    /// Consolidated test data for all callback validation scenarios.
+    /// Combines valid patterns (should not trigger diagnostics) and invalid patterns (should trigger diagnostics).
+    /// </summary>
+    /// <returns>Test data for comprehensive callback validation scenarios.</returns>
+    public static IEnumerable<object[]> CallbackValidationData()
+    {
+        // Valid patterns that should NOT trigger the analyzer
+        IEnumerable<object[]> validPatterns = new object[][]
+        {
+            // Multiple callbacks with correct signatures
+            ["""new Mock<IFoo>().Setup(x => x.DoWork("test")).Callback(() => { }).Returns(42).Callback(() => { });"""],
+
+            // Ref parameter with correct signature
+            ["""new Mock<IFoo>().Setup(m => m.DoRef(ref It.Ref<string>.IsAny)).Callback((ref string data) => { });"""],
+
+            // Out parameter with correct signature
+            ["""new Mock<IFoo>().Setup(m => m.DoOut(out It.Ref<int>.IsAny)).Callback((out int result) => { result = 42; });"""],
+
+            // Basic callback with correct parameter type
+            ["""new Mock<IFoo>().Setup(x => x.DoWork("test")).Callback((string param) => { });"""],
+
+            // No parameters callback for parameterized method (valid pattern)
+            ["""new Mock<IFoo>().Setup(x => x.DoWork("test")).Callback(() => { });"""],
+
+            // Complex multiple parameter with correct signatures
+            ["""new Mock<IFoo>().Setup(x => x.ProcessMultiple(It.IsAny<int>(), It.IsAny<string>(), It.IsAny<DateTime>())).Callback((int id, string name, DateTime timestamp) => { });"""],
+        }.WithNamespaces().WithMoqReferenceAssemblyGroups();
+
+        // Invalid patterns that SHOULD trigger the analyzer
+        IEnumerable<object[]> invalidPatterns = new object[][]
+        {
+            // Basic callback with wrong parameter type
+            ["""new Mock<IFoo>().Setup(x => x.DoWork("test")).Callback(({|Moq1100:int wrongParam|}) => { });"""],
+
+            // Ref parameter mismatch (missing ref)
+            ["""new Mock<IFoo>().Setup(m => m.DoRef(ref It.Ref<string>.IsAny)).Callback(({|Moq1100:string data|}) => { });"""],
+
+            // Out parameter mismatch (missing out)
+            ["""new Mock<IFoo>().Setup(m => m.DoOut(out It.Ref<int>.IsAny)).Callback(({|Moq1100:int result|}) => { });"""],
+        }.WithNamespaces().WithMoqReferenceAssemblyGroups();
+
+        return validPatterns.Concat(invalidPatterns);
+    }
+
+    [Theory]
+    [MemberData(nameof(CallbackValidationData))]
+    public async Task ShouldValidateCallbackPatterns(string referenceAssemblyGroup, string @namespace, string testCode)
+    {
+        static string Template(string ns, string code) =>
+            $$"""
+            {{ns}}
+
+            public interface IFoo
+            {
+                int DoWork(string input);
+                bool ProcessMultiple(int id, string name, DateTime timestamp);
+                void ProcessData(ref string data);
+                bool TryProcess(out int result);
+                void ProcessMixed(int id, ref string data, out bool success);
+                void ProcessReadOnly(in DateTime timestamp);
+                int DoRef(ref string data);
+                bool DoOut(out int result);
+                string DoIn(in DateTime timestamp);
+                T ProcessGeneric<T>(T input);
+            }
+
+            public class TestClass
+            {
+                public void TestMethod()
+                {
+                    {{code}}
+                }
+            }
+            """;
+
+        string source = Template(@namespace, testCode);
+        output.WriteLine(source);
+        await AnalyzerVerifier.VerifyAnalyzerAsync(source, referenceAssemblyGroup);
+    }
+
+    /// <summary>
+    /// Test to document the current limitation with generic callback validation.
+    /// This test documents that .Callback&lt;T&gt;() with wrong type parameters is NOT currently validated.
+    /// This could be enhanced in a future version.
+    /// </summary>
+    /// <returns>A task representing the asynchronous unit test.</returns>
+    [Fact]
+    public async Task GenericCallbackValidation_CurrentLimitation_IsDocumented()
+    {
+        const string source = """
+            using Moq;
+
+            public interface IFoo
+            {
+                int DoWork(string input);
+            }
+
+            public class TestClass
+            {
+                public void TestGenericCallback()
+                {
+                    var mock = new Mock<IFoo>();
+                    // Note: This currently does NOT trigger a diagnostic, which could be enhanced in the future
+                    mock.Setup(x => x.DoWork("test"))
+                        .Callback<int>(wrongTypeParam => { }); // Should ideally trigger Moq1100 but currently doesn't
+                }
+            }
+            """;
+
+        // This test documents the current limitation - no diagnostic is expected
+        await AnalyzerVerifier.VerifyAnalyzerAsync(source, "Net80WithOldMoq");
+    }
+}