diff --git a/clang-tools-extra/include-cleaner/lib/Analysis.cpp b/clang-tools-extra/include-cleaner/lib/Analysis.cpp
index a1781f4e24f2..e48a380211af 100644
--- a/clang-tools-extra/include-cleaner/lib/Analysis.cpp
+++ b/clang-tools-extra/include-cleaner/lib/Analysis.cpp
@@ -58,7 +58,19 @@ void walkUsed(llvm::ArrayRef<Decl *> ASTRoots,
   tooling::stdlib::Recognizer Recognizer;
   for (auto *Root : ASTRoots) {
     walkAST(*Root, [&](SourceLocation Loc, NamedDecl &ND, RefType RT) {
-      auto FID = SM.getFileID(SM.getSpellingLoc(Loc));
+      auto SpellLoc = SM.getSpellingLoc(Loc);
+      // Tokens resulting from macro concatenation ends up in scratch space and
+      // clang currently doesn't have a good/simple APIs for tracking where
+      // pieces of a concataned token originated from.
+      // So we use the macro expansion location instead, and downgrade reference
+      // type to ambigious to prevent false negatives.
+      if (SM.isWrittenInScratchSpace(SpellLoc)) {
+        Loc = SM.getExpansionLoc(Loc);
+        if (RT == RefType::Explicit)
+          RT = RefType::Ambiguous;
+        SpellLoc = SM.getSpellingLoc(Loc);
+      }
+      auto FID = SM.getFileID(SpellLoc);
       if (FID != SM.getMainFileID() && FID != SM.getPreambleFileID())
         return;
       // FIXME: Most of the work done here is repetitive. It might be useful to
diff --git a/clang-tools-extra/include-cleaner/unittests/AnalysisTest.cpp b/clang-tools-extra/include-cleaner/unittests/AnalysisTest.cpp
index 74321c312cb7..ba5a3fbbcaeb 100644
--- a/clang-tools-extra/include-cleaner/unittests/AnalysisTest.cpp
+++ b/clang-tools-extra/include-cleaner/unittests/AnalysisTest.cpp
@@ -680,5 +680,31 @@ TEST_F(WalkUsedTest, IgnoresIdentityMacros) {
                   // FIXME: we should have a reference from stdin to header.h
                   Pair(Code.point("bar"), UnorderedElementsAre(MainFile))));
 }
+
+TEST_F(WalkUsedTest, MacroConcat) {
+  llvm::Annotations Code(R"cpp(
+  #include "header.h"
+  void f() {
+    $xyz^FOO(xyz) = 1;
+    $bar^BAR = 2;
+  }
+  )cpp");
+  Inputs.Code = Code.code();
+  Inputs.ExtraFiles["header.h"] = guard(R"cpp(
+  #define FOO(x) FLAGS_##x
+  #define BAR FOO(bb)
+
+  int FLAGS_xyz;
+  int FLAGS_bb;
+  )cpp");
+
+  TestAST AST(Inputs);
+  auto &SM = AST.sourceManager();
+  auto Header = *SM.getFileManager().getOptionalFileRef("header.h");
+  EXPECT_THAT(
+      offsetToProviders(AST),
+      AllOf(Contains(Pair(Code.point("bar"), UnorderedElementsAre(Header))),
+            Contains(Pair(Code.point("xyz"), UnorderedElementsAre(Header)))));
+}
 } // namespace
 } // namespace clang::include_cleaner