diff --git a/.changeset/fix-better-sqlite3.md b/.changeset/fix-better-sqlite3.md
new file mode 100644
index 000000000..d8353bac1
--- /dev/null
+++ b/.changeset/fix-better-sqlite3.md
@@ -0,0 +1,5 @@
+---
+"@powersync/node": patch
+---
+
+Fix loading `better-sqlite3` on CommonJS builds.
diff --git a/packages/node/src/db/SqliteWorker.ts b/packages/node/src/db/SqliteWorker.ts
index a887e85e5..87078784a 100644
--- a/packages/node/src/db/SqliteWorker.ts
+++ b/packages/node/src/db/SqliteWorker.ts
@@ -84,7 +84,8 @@ export function startPowerSyncWorker(options?: Partial<PowerSyncWorkerOptions>)
     },
     async loadBetterSqlite3() {
       const module = await dynamicImport('better-sqlite3');
-      return module.default;
+      // require() gives us the default directly, for an ESM import() we need to use the default export.
+      return isBundledToCommonJs ? module : module.default;
     },
     ...options
   };