diff --git a/compio-driver/src/iocp/op.rs b/compio-driver/src/iocp/op.rs
index 658c49b1..b123b5b9 100644
--- a/compio-driver/src/iocp/op.rs
+++ b/compio-driver/src/iocp/op.rs
@@ -22,7 +22,7 @@ use windows_sys::{
         Foundation::{
             CloseHandle, GetLastError, ERROR_ACCESS_DENIED, ERROR_HANDLE_EOF, ERROR_IO_INCOMPLETE,
             ERROR_IO_PENDING, ERROR_NOT_FOUND, ERROR_NO_DATA, ERROR_PIPE_CONNECTED,
-            ERROR_SHARING_VIOLATION, FILETIME,
+            ERROR_SHARING_VIOLATION, FILETIME, INVALID_HANDLE_VALUE,
         },
         Networking::WinSock::{
             closesocket, setsockopt, shutdown, socklen_t, WSAIoctl, WSARecv, WSARecvFrom, WSASend,
@@ -144,6 +144,7 @@ pub struct OpenFile {
     pub(crate) security_attributes: *const SECURITY_ATTRIBUTES,
     pub(crate) creation_mode: FILE_CREATION_DISPOSITION,
     pub(crate) flags_and_attributes: FILE_FLAGS_AND_ATTRIBUTES,
+    pub(crate) error_code: u32,
 }
 
 impl OpenFile {
@@ -163,8 +164,15 @@ impl OpenFile {
             security_attributes,
             creation_mode,
             flags_and_attributes,
+            error_code: 0,
         }
     }
+
+    /// The result of [`GetLastError`]. It may not be 0 even if the operation is
+    /// successful.
+    pub fn last_os_error(&self) -> u32 {
+        self.error_code
+    }
 }
 
 impl OpCode for OpenFile {
@@ -172,19 +180,22 @@ impl OpCode for OpenFile {
         false
     }
 
-    unsafe fn operate(self: Pin<&mut Self>, _optr: *mut OVERLAPPED) -> Poll<io::Result<usize>> {
-        Poll::Ready(Ok(syscall!(
-            HANDLE,
-            CreateFileW(
-                self.path.as_ptr(),
-                self.access_mode,
-                self.share_mode,
-                self.security_attributes,
-                self.creation_mode,
-                self.flags_and_attributes,
-                0
-            )
-        )? as _))
+    unsafe fn operate(mut self: Pin<&mut Self>, _optr: *mut OVERLAPPED) -> Poll<io::Result<usize>> {
+        let handle = CreateFileW(
+            self.path.as_ptr(),
+            self.access_mode,
+            self.share_mode,
+            self.security_attributes,
+            self.creation_mode,
+            self.flags_and_attributes,
+            0,
+        );
+        self.error_code = GetLastError();
+        if handle == INVALID_HANDLE_VALUE {
+            Poll::Ready(Err(io::Error::from_raw_os_error(self.error_code as _)))
+        } else {
+            Poll::Ready(Ok(handle as _))
+        }
     }
 }
 
diff --git a/compio-fs/src/open_options/windows.rs b/compio-fs/src/open_options/windows.rs
index ac130535..004314a6 100644
--- a/compio-fs/src/open_options/windows.rs
+++ b/compio-fs/src/open_options/windows.rs
@@ -1,14 +1,16 @@
 use std::{io, path::Path, ptr::null};
 
-use compio_driver::{op::OpenFile, FromRawFd, RawFd};
+use compio_buf::BufResult;
+use compio_driver::{op::OpenFile, syscall, FromRawFd, RawFd};
 use compio_runtime::Runtime;
 use windows_sys::Win32::{
-    Foundation::{ERROR_INVALID_PARAMETER, GENERIC_READ, GENERIC_WRITE},
+    Foundation::{ERROR_ALREADY_EXISTS, ERROR_INVALID_PARAMETER, GENERIC_READ, GENERIC_WRITE},
     Security::SECURITY_ATTRIBUTES,
     Storage::FileSystem::{
-        CREATE_ALWAYS, CREATE_NEW, FILE_FLAGS_AND_ATTRIBUTES, FILE_FLAG_OPEN_REPARSE_POINT,
-        FILE_FLAG_OVERLAPPED, FILE_SHARE_DELETE, FILE_SHARE_MODE, FILE_SHARE_READ,
-        FILE_SHARE_WRITE, OPEN_ALWAYS, OPEN_EXISTING, SECURITY_SQOS_PRESENT, TRUNCATE_EXISTING,
+        FileAllocationInfo, SetFileInformationByHandle, CREATE_NEW, FILE_ALLOCATION_INFO,
+        FILE_FLAGS_AND_ATTRIBUTES, FILE_FLAG_OPEN_REPARSE_POINT, FILE_FLAG_OVERLAPPED,
+        FILE_SHARE_DELETE, FILE_SHARE_MODE, FILE_SHARE_READ, FILE_SHARE_WRITE, OPEN_ALWAYS,
+        OPEN_EXISTING, SECURITY_SQOS_PRESENT, TRUNCATE_EXISTING,
     },
 };
 
@@ -112,7 +114,8 @@ impl OpenOptions {
             (false, false, false) => OPEN_EXISTING,
             (true, false, false) => OPEN_ALWAYS,
             (false, true, false) => TRUNCATE_EXISTING,
-            (true, true, false) => CREATE_ALWAYS,
+            // https://github.com/rust-lang/rust/issues/115745
+            (true, true, false) => OPEN_ALWAYS,
             (_, _, true) => CREATE_NEW,
         })
     }
@@ -131,15 +134,32 @@ impl OpenOptions {
 
     pub async fn open(&self, p: impl AsRef<Path>) -> io::Result<File> {
         let p = path_string(p)?;
+        let creation_mode = self.get_creation_mode()?;
         let op = OpenFile::new(
             p,
             self.get_access_mode()?,
             self.share_mode,
             self.security_attributes,
-            self.get_creation_mode()?,
+            creation_mode,
             self.get_flags_and_attributes(),
         );
-        let fd = Runtime::current().submit(op).await.0? as RawFd;
+        let BufResult(fd, op) = Runtime::current().submit(op).await;
+        let fd = fd? as RawFd;
+        if self.truncate
+            && creation_mode == OPEN_ALWAYS
+            && op.last_os_error() == ERROR_ALREADY_EXISTS
+        {
+            let alloc = FILE_ALLOCATION_INFO { AllocationSize: 0 };
+            syscall!(
+                BOOL,
+                SetFileInformationByHandle(
+                    fd as _,
+                    FileAllocationInfo,
+                    std::ptr::addr_of!(alloc).cast(),
+                    std::mem::size_of::<FILE_ALLOCATION_INFO>() as _,
+                )
+            )?;
+        }
         Ok(unsafe { File::from_raw_fd(fd) })
     }
 }
diff --git a/compio-fs/tests/file.rs b/compio-fs/tests/file.rs
index dff8fb6b..96f1b602 100644
--- a/compio-fs/tests/file.rs
+++ b/compio-fs/tests/file.rs
@@ -78,6 +78,30 @@ async fn drop_open() {
     assert_eq!(file, HELLO);
 }
 
+#[cfg(windows)]
+#[compio_macros::test]
+async fn hidden_file_truncation() {
+    let tmpdir = tempfile::tempdir().unwrap();
+    let path = tmpdir.path().join("hidden_file.txt");
+
+    // Create a hidden file.
+    const FILE_ATTRIBUTE_HIDDEN: u32 = 2;
+    let mut file = compio_fs::OpenOptions::new()
+        .write(true)
+        .create_new(true)
+        .attributes(FILE_ATTRIBUTE_HIDDEN)
+        .open(&path)
+        .await
+        .unwrap();
+    file.write_all_at("hidden world!", 0).await.unwrap();
+    file.close().await.unwrap();
+
+    // Create a new file by truncating the existing one.
+    let file = File::create(&path).await.unwrap();
+    let metadata = file.metadata().await.unwrap();
+    assert_eq!(metadata.len(), 0);
+}
+
 fn tempfile() -> NamedTempFile {
     NamedTempFile::new().unwrap()
 }