diff --git a/Misc/NEWS.d/next/Build/2024-02-24-12-50-43.gh-issue-115350.naQA6y.rst b/Misc/NEWS.d/next/Build/2024-02-24-12-50-43.gh-issue-115350.naQA6y.rst
new file mode 100644
index 000000000000000..5492a804255838c
--- /dev/null
+++ b/Misc/NEWS.d/next/Build/2024-02-24-12-50-43.gh-issue-115350.naQA6y.rst
@@ -0,0 +1 @@
+Fix building ctypes module with -DWIN32_LEAN_AND_MEAN defined
diff --git a/Modules/_ctypes/ctypes.h b/Modules/_ctypes/ctypes.h
index 1989723f6f3dbb1..02f48a9ed55843c 100644
--- a/Modules/_ctypes/ctypes.h
+++ b/Modules/_ctypes/ctypes.h
@@ -32,6 +32,10 @@
 #endif
 #endif
 
+#ifdef MS_WIN32
+#include <Unknwn.h> // for IUnknown interface
+#endif
+
 typedef struct {
     PyTypeObject *DictRemover_Type;
     PyTypeObject *PyCArg_Type;