diff --git a/changelog.d/20368.feature b/changelog.d/20368.feature
new file mode 100644
index 0000000000..017f3f7b0b
--- /dev/null
+++ b/changelog.d/20368.feature
@@ -0,0 +1 @@
+Avoid reading media from disk when answering a `HEAD` request to the media download endpoints.
diff --git a/synapse/media/_base.py b/synapse/media/_base.py
index 7884930876..5f3ebc7796 100644
--- a/synapse/media/_base.py
+++ b/synapse/media/_base.py
@@ -146,6 +146,11 @@ async def respond_with_file(
 
         add_file_headers(request, media_type, file_size, upload_name)
 
+        if request.get_method() == "HEAD":
+            # Twisted does not send a body for HEAD requests. Do not read the media.
+            finish_request(request)
+            return
+
         with open(file_path, "rb") as f:
             await ThreadedFileSender(hs).beginFileTransfer(f, request)
 
@@ -375,6 +380,11 @@ async def respond_with_multipart_responder(
             b"multipart/mixed; boundary=%s" % multipart_consumer.boundary,
         )
 
+        if request.get_method() == "HEAD":
+            # Twisted does not send a body for HEAD requests. Do not read the media.
+            finish_request(request)
+            return
+
         try:
             await responder.write_to_consumer(multipart_consumer)
         except ConsumerRequestedStopError as e:
@@ -422,6 +432,12 @@ async def respond_with_responder(
 
         logger.debug("Responding to media request with responder %s", responder)
         add_file_headers(request, media_type, file_size, upload_name)
+
+        if request.get_method() == "HEAD":
+            # Twisted does not send a body for HEAD requests. Do not read the media.
+            finish_request(request)
+            return
+
         try:
             await responder.write_to_consumer(request)
         except ConsumerRequestedStopError as e:
diff --git a/tests/federation/test_federation_media.py b/tests/federation/test_federation_media.py
index 9c4e813537..666b9fed3a 100644
--- a/tests/federation/test_federation_media.py
+++ b/tests/federation/test_federation_media.py
@@ -21,6 +21,7 @@ import io
 import os
 import shutil
 import tempfile
+from unittest.mock import patch
 
 from twisted.internet.testing import MemoryReactor
 
@@ -148,6 +149,34 @@ class FederationMediaDownloadsTest(unittest.FederatingHomeserverTestCase):
         found_file = any(SMALL_PNG in field for field in stripped_bytes)
         self.assertTrue(found_file)
 
+    def test_head_file_download_does_not_read_file(self) -> None:
+        content_uri = self.get_success(
+            self.media_repo.create_or_update_content(
+                "image/png",
+                "test_png_upload",
+                io.BytesIO(SMALL_PNG),
+                67,
+                UserID.from_string("@user_id:whatever.org"),
+            )
+        )
+
+        with patch(
+            "synapse.media._base.ThreadedFileSender.beginFileTransfer"
+        ) as begin_file_transfer:
+            channel = self.make_signed_federation_request(
+                "HEAD",
+                f"/_matrix/federation/v1/media/download/{content_uri.media_id}",
+            )
+            self.pump()
+
+        self.assertEqual(200, channel.code)
+        content_type = channel.headers.getRawHeaders("content-type")
+        assert content_type is not None
+        self.assertIn("multipart/mixed", content_type[0])
+        self.assertEqual(channel.is_finished(), True)
+        self.assertEqual(channel.result.get("body", b""), b"")
+        begin_file_transfer.assert_not_called()
+
     def test_federation_etag(self) -> None:
         """Test that federation ETags work"""
 
diff --git a/tests/rest/client/test_media.py b/tests/rest/client/test_media.py
index 31d8f3de35..d8d87b7c69 100644
--- a/tests/rest/client/test_media.py
+++ b/tests/rest/client/test_media.py
@@ -2652,6 +2652,37 @@ class AuthenticatedMediaTestCase(unittest.HomeserverTestCase):
         resources["/_matrix/media"] = self.hs.get_media_repository_resource()
         return resources
 
+    def test_head_download_does_not_read_file(self) -> None:
+        channel = self.make_request(
+            "POST",
+            "_matrix/media/v3/upload?filename=test_png_upload",
+            SMALL_PNG,
+            self.tok,
+            shorthand=False,
+            content_type=b"image/png",
+        )
+        self.assertEqual(channel.code, 200)
+        uri = channel.json_body["content_uri"].split("mxc://")[1]
+
+        with patch(
+            "synapse.media._base.ThreadedFileSender.beginFileTransfer"
+        ) as begin_file_transfer:
+            channel = self.make_request(
+                "HEAD",
+                f"_matrix/client/v1/media/download/{uri}",
+                access_token=self.tok,
+                shorthand=False,
+            )
+
+        self.assertEqual(channel.code, 200)
+        self.assertEqual(
+            channel.headers.getRawHeaders(b"Content-Length"),
+            [str(len(SMALL_PNG)).encode()],
+        )
+        self.assertEqual(channel.headers.getRawHeaders(b"Content-Type"), [b"image/png"])
+        self.assertEqual(channel.result.get("body", b""), b"")
+        begin_file_transfer.assert_not_called()
+
     def test_authenticated_media(self) -> None:
         # upload some local media with authentication on
         channel = self.make_request(