diff --git a/pyproject.toml b/pyproject.toml
index ac1c87a2..560e979d 100644
--- a/pyproject.toml
+++ b/pyproject.toml
@@ -118,6 +118,7 @@ ignore_missing_imports = true
 
 [tool.ruff]
 target-version = "py310"
+exclude = ["src/ocrmypdf/_version.py"] # Autogenerated
 
 [tool.ruff.lint]
 "select" = [
@@ -131,7 +132,9 @@ target-version = "py310"
   "B",   # flake8-bugbear
 ]
 ignore = [
-  "B028", # warn no explicit stacklevel
+  "B028", # warning with no explicit stacklevel
+  # rule is key in dict instead of key in dict.keys(); but pikepdf semantics differ
+  "SIM118",
 ]
 
 [tool.ruff.lint.isort]
@@ -150,7 +153,7 @@ convention = "google"
 quote-style = "preserve"
 
 [dependency-groups]
-# Developer-only tools - use `uv sync --group <name>` (NOT pip-installable)
+# Developer-only tools - use `uv sync --group <name>`
 dev = ["mypy>=1.13.0", "ipykernel>=6.29.5"]
 test = [
   # Core testing framework
diff --git a/src/ocrmypdf/builtin_plugins/pypdfium.py b/src/ocrmypdf/builtin_plugins/pypdfium.py
index 15a9ac6e..1c52d5fc 100644
--- a/src/ocrmypdf/builtin_plugins/pypdfium.py
+++ b/src/ocrmypdf/builtin_plugins/pypdfium.py
@@ -14,6 +14,8 @@ try:
 except ImportError:
     pdfium = None
 
+from PIL import Image
+
 from ocrmypdf import hookimpl
 from ocrmypdf.exceptions import MissingDependencyError
 from ocrmypdf.helpers import Resolution
@@ -74,6 +76,16 @@ def _render_page_to_bitmap(
     use_cropbox: bool,
 ):
     """Render a PDF page to a bitmap."""
+    # Round DPI to match Ghostscript's precision
+    raster_dpi = raster_dpi.round(6)
+
+    # Get page dimensions BEFORE applying rotation
+    page_width_pts, page_height_pts = page.get_size()
+
+    # Calculate expected output dimensions using separate x/y DPI
+    expected_width = int(round(page_width_pts * raster_dpi.x / 72.0))
+    expected_height = int(round(page_height_pts * raster_dpi.y / 72.0))
+
     # Calculate the scale factor based on DPI
     # pypdfium2 uses points (72 DPI) as base unit
     scale = raster_dpi.to_scalar() / 72.0
@@ -83,6 +95,9 @@ def _render_page_to_bitmap(
         # pypdfium2 rotation is in degrees, same as our input
         # we track rotation in CCW, and pypdfium2 expects CW, so negate
         page.set_rotation(-rotation % 360)
+        # When rotation is 90 or 270, dimensions are swapped in output
+        if rotation % 180 == 90:
+            expected_width, expected_height = expected_height, expected_width
 
     # Render the page to a bitmap
     # The scale parameter controls the resolution
@@ -102,7 +117,7 @@ def _render_page_to_bitmap(
         # Note: pypdfium2 doesn't have a direct equivalent to filter_vector
         # This would require more complex implementation if needed
     )
-    return bitmap
+    return bitmap, expected_width, expected_height
 
 
 def _process_image_for_output(
@@ -111,8 +126,30 @@ def _process_image_for_output(
     raster_dpi: Resolution,
     page_dpi: Resolution | None,
     stop_on_soft_error: bool,
+    expected_width: int | None = None,
+    expected_height: int | None = None,
 ):
     """Process PIL image for output format and set DPI metadata."""
+    # Correct dimensions if slightly off (within 2 pixels tolerance)
+    if expected_width and expected_height:
+        actual_width, actual_height = pil_image.width, pil_image.height
+        width_diff = abs(actual_width - expected_width)
+        height_diff = abs(actual_height - expected_height)
+
+        # Only resize if off by small amount (1-2 pixels)
+        if (width_diff <= 2 or height_diff <= 2) and (
+            width_diff > 0 or height_diff > 0
+        ):
+            log.debug(
+                f"Adjusting rendered dimensions from "
+                f"{actual_width}x{actual_height} to expected "
+                f"{expected_width}x{expected_height}"
+            )
+            pil_image = pil_image.resize(
+                (expected_width, expected_height),
+                Image.Resampling.LANCZOS
+            )
+
     # Set the DPI metadata if page_dpi is specified
     if page_dpi:
         # PIL expects DPI as a tuple
@@ -196,7 +233,7 @@ def rasterize_pdf_page(
         closing(pdf[pageno - 1]) as page,
     ):
         # Render the page to a bitmap
-        bitmap = _render_page_to_bitmap(
+        bitmap, expected_width, expected_height = _render_page_to_bitmap(
             page, raster_device, raster_dpi, rotation, use_cropbox
         )
         with closing(bitmap):
@@ -205,7 +242,13 @@ def rasterize_pdf_page(
 
     # Process and save image outside the lock (PIL operations are thread-safe)
     pil_image, format_name = _process_image_for_output(
-        pil_image, raster_device, raster_dpi, page_dpi, stop_on_soft_error
+        pil_image,
+        raster_device,
+        raster_dpi,
+        page_dpi,
+        stop_on_soft_error,
+        expected_width,
+        expected_height,
     )
 
     _save_image(pil_image, output_file, format_name)
diff --git a/tests/test_rotation.py b/tests/test_rotation.py
index e4dfe712..e881d3ee 100644
--- a/tests/test_rotation.py
+++ b/tests/test_rotation.py
@@ -146,7 +146,8 @@ def test_autorotate_threshold(threshold, op, comparison_threshold, resources, ou
     assert op(cmp, comparison_threshold)
 
 
-def test_rotated_skew_timeout(resources, outpdf):
+@pytest.mark.parametrize('rasterizer', ['pypdfium', 'ghostscript'])
+def test_rotated_skew_timeout(resources, outpdf, rasterizer):
     """Check rotated skew timeout.
 
     This document contains an image that is rotated 90 into place with a
@@ -172,7 +173,7 @@ def test_rotated_skew_timeout(resources, outpdf):
         '--tesseract-timeout',
         '0',
         '--rasterizer',
-        'ghostscript',  # Use Ghostscript for consistent dimensions
+        rasterizer,
     )
 
     out_pageinfo = PdfInfo(out)[0]
@@ -187,7 +188,8 @@ def test_rotated_skew_timeout(resources, outpdf):
     ), "Expected page rotation to be baked in"
 
 
-def test_rotate_deskew_ocr_timeout(resources, outdir):
+@pytest.mark.parametrize('rasterizer', ['pypdfium', 'ghostscript'])
+def test_rotate_deskew_ocr_timeout(resources, outdir, rasterizer):
     check_ocrmypdf(
         resources / 'rotated_skew.pdf',
         outdir / 'deskewed.pdf',
@@ -200,7 +202,7 @@ def test_rotate_deskew_ocr_timeout(resources, outdir):
         '--pdf-renderer',
         'fpdf2',
         '--rasterizer',
-        'ghostscript',  # Use Ghostscript for consistent dimensions
+        rasterizer,
     )
 
     cmp = compare_images_monochrome(
@@ -212,7 +214,9 @@ def test_rotate_deskew_ocr_timeout(resources, outdir):
     )
 
     # Confirm that the page still got deskewed
-    assert cmp > 0.95
+    # pypdfium anti-aliases so gets better visual quality, but lower score (0.88)
+    # on monochrome comparison; ghostscript looks ugly but gets > 0.95
+    assert cmp > 0.85
 
 
 def make_rotate_test(imagefile, outdir, prefix, image_angle, page_angle, cropbox=None):
@@ -328,7 +332,8 @@ def test_rotate_and_crop(
     assert compare_images_monochrome(outdir, reference, 1, out, 1) > 0.9
 
 
-def test_rasterize_rotates(resources, tmp_path):
+@pytest.mark.parametrize('rasterizer', ['pypdfium', 'ghostscript'])
+def test_rasterize_rotates(resources, tmp_path, rasterizer):
     from ocrmypdf._options import OcrOptions
 
     pm = get_plugin_manager([])
@@ -336,7 +341,7 @@ def test_rasterize_rotates(resources, tmp_path):
     options = OcrOptions(
         input_file=resources / 'graph.pdf',
         output_file=tmp_path / 'out.pdf',
-        rasterizer='ghostscript',  # Use Ghostscript for consistent dimensions
+        rasterizer=rasterizer,
     )
 
     img = tmp_path / 'img90.png'