diff --git a/src/common/config.cpp b/src/common/config.cpp
index 6997f7276..4e2298d2a 100644
--- a/src/common/config.cpp
+++ b/src/common/config.cpp
@@ -136,10 +136,14 @@ static ConfigEntry<bool> useSpecialPad(false);
 static ConfigEntry<int> specialPadClass(1);
 static ConfigEntry<bool> isMotionControlsEnabled(true);
 static ConfigEntry<bool> useUnifiedInputConfig(true);
-static ConfigEntry<string> micDevice("Default Device");
 static ConfigEntry<string> defaultControllerID("");
 static ConfigEntry<bool> backgroundControllerInput(false);
 
+// Audio
+static ConfigEntry<string> micDevice("Default Device");
+static ConfigEntry<string> mainOutputDevice("Default Device");
+static ConfigEntry<string> padSpkOutputDevice("Default Device");
+
 // GPU
 static ConfigEntry<u32> windowWidth(1280);
 static ConfigEntry<u32> windowHeight(720);
@@ -302,6 +306,14 @@ string getMicDevice() {
     return micDevice.get();
 }
 
+std::string getMainOutputDevice() {
+    return mainOutputDevice.get();
+}
+
+std::string getPadSpkOutputDevice() {
+    return padSpkOutputDevice.get();
+}
+
 double getTrophyNotificationDuration() {
     return trophyNotificationDuration.get();
 }
@@ -581,10 +593,18 @@ void setCursorHideTimeout(int newcursorHideTimeout, bool is_game_specific) {
     cursorHideTimeout.set(newcursorHideTimeout, is_game_specific);
 }
 
-void setMicDevice(string device, bool is_game_specific) {
+void setMicDevice(std::string device, bool is_game_specific) {
     micDevice.set(device, is_game_specific);
 }
 
+void setMainOutputDevice(std::string device, bool is_game_specific) {
+    mainOutputDevice.set(device, is_game_specific);
+}
+
+void setPadSpkOutputDevice(std::string device, bool is_game_specific) {
+    padSpkOutputDevice.set(device, is_game_specific);
+}
+
 void setTrophyNotificationDuration(double newTrophyNotificationDuration, bool is_game_specific) {
     trophyNotificationDuration.set(newTrophyNotificationDuration, is_game_specific);
 }
@@ -826,10 +846,17 @@ void load(const std::filesystem::path& path, bool is_game_specific) {
         specialPadClass.setFromToml(input, "specialPadClass", is_game_specific);
         isMotionControlsEnabled.setFromToml(input, "isMotionControlsEnabled", is_game_specific);
         useUnifiedInputConfig.setFromToml(input, "useUnifiedInputConfig", is_game_specific);
-        micDevice.setFromToml(input, "micDevice", is_game_specific);
         backgroundControllerInput.setFromToml(input, "backgroundControllerInput", is_game_specific);
     }
 
+    if (data.contains("Audio")) {
+        const toml::value& audio = data.at("Audio");
+
+        micDevice.setFromToml(audio, "micDevice", is_game_specific);
+        mainOutputDevice.setFromToml(audio, "mainOutputDevice", is_game_specific);
+        padSpkOutputDevice.setFromToml(audio, "padSpkOutputDevice", is_game_specific);
+    }
+
     if (data.contains("GPU")) {
         const toml::value& gpu = data.at("GPU");
 
@@ -999,10 +1026,13 @@ void save(const std::filesystem::path& path, bool is_game_specific) {
     cursorHideTimeout.setTomlValue(data, "Input", "cursorHideTimeout", is_game_specific);
     isMotionControlsEnabled.setTomlValue(data, "Input", "isMotionControlsEnabled",
                                          is_game_specific);
-    micDevice.setTomlValue(data, "Input", "micDevice", is_game_specific);
     backgroundControllerInput.setTomlValue(data, "Input", "backgroundControllerInput",
                                            is_game_specific);
 
+    micDevice.setTomlValue(data, "Audio", "micDevice", is_game_specific);
+    mainOutputDevice.setTomlValue(data, "Audio", "mainOutputDevice", is_game_specific);
+    padSpkOutputDevice.setTomlValue(data, "Audio", "padSpkOutputDevice", is_game_specific);
+
     windowWidth.setTomlValue(data, "GPU", "screenWidth", is_game_specific);
     windowHeight.setTomlValue(data, "GPU", "screenHeight", is_game_specific);
     isNullGpu.setTomlValue(data, "GPU", "nullGpu", is_game_specific);
@@ -1036,9 +1066,8 @@ void save(const std::filesystem::path& path, bool is_game_specific) {
 
     m_language.setTomlValue(data, "Settings", "consoleLanguage", is_game_specific);
 
-    // All other entries
     if (!is_game_specific) {
-        std::vector<string> install_dirs;
+        std::vector<std::string> install_dirs;
         std::vector<bool> install_dirs_enabled;
 
         // temporary structure for ordering
@@ -1077,23 +1106,18 @@ void save(const std::filesystem::path& path, bool is_game_specific) {
         data["GUI"]["loadGameSizeEnabled"] = load_game_size;
         data["GUI"]["addonInstallDir"] =
             string{fmt::UTF(settings_addon_install_dir.u8string()).data};
-
         data["Debug"]["ConfigVersion"] = config_version;
         data["Keys"]["TrophyKey"] = trophyKey;
 
         // Do not save these entries in the game-specific dialog since they are not in the GUI
         data["General"]["defaultControllerID"] = defaultControllerID.base_value;
-
         data["Input"]["useSpecialPad"] = useSpecialPad.base_value;
         data["Input"]["specialPadClass"] = specialPadClass.base_value;
         data["Input"]["useUnifiedInputConfig"] = useUnifiedInputConfig.base_value;
-
         data["GPU"]["internalScreenWidth"] = internalScreenWidth.base_value;
         data["GPU"]["internalScreenHeight"] = internalScreenHeight.base_value;
         data["GPU"]["patchShaders"] = shouldPatchShaders.base_value;
-
         data["Vulkan"]["validation_gpu"] = vkValidationGpu.base_value;
-
         data["Debug"]["FPSColor"] = isFpsColor.base_value;
     }
 
@@ -1135,9 +1159,11 @@ void setDefaultValues(bool is_game_specific) {
     cursorState.set(HideCursorState::Idle, is_game_specific);
     cursorHideTimeout.set(5, is_game_specific);
     isMotionControlsEnabled.set(true, is_game_specific);
-    micDevice.set("Default Device", is_game_specific);
     backgroundControllerInput.set(false, is_game_specific);
 
+    // GS - Audio
+    micDevice.set("Default Device", is_game_specific);
+
     // GS - GPU
     windowWidth.set(1280, is_game_specific);
     windowHeight.set(720, is_game_specific);
@@ -1184,11 +1210,14 @@ void setDefaultValues(bool is_game_specific) {
         useSpecialPad.base_value = false;
         specialPadClass.base_value = 1;
         useUnifiedInputConfig.base_value = true;
-        overrideControllerColor = false;
         controllerCustomColorRGB[0] = 0;
         controllerCustomColorRGB[1] = 0;
         controllerCustomColorRGB[2] = 255;
 
+        // TODO: Change to be game specific
+        mainOutputDevice = "Default Device";
+        padSpkOutputDevice = "Default Device";
+
         // GPU
         shouldPatchShaders.base_value = false;
         internalScreenWidth.base_value = 1280;
diff --git a/src/common/config.h b/src/common/config.h
index 1e285a13b..c4c35560f 100644
--- a/src/common/config.h
+++ b/src/common/config.h
@@ -90,6 +90,11 @@ double getTrophyNotificationDuration();
 void setTrophyNotificationDuration(double newTrophyNotificationDuration,
                                    bool is_game_specific = false);
 int getCursorHideTimeout();
+void setCursorHideTimeout(int newcursorHideTimeout);
+std::string getMainOutputDevice();
+void setMainOutputDevice(std::string device);
+std::string getPadSpkOutputDevice();
+void setPadSpkOutputDevice(std::string device);
 std::string getMicDevice();
 void setCursorHideTimeout(int newcursorHideTimeout, bool is_game_specific = false);
 void setMicDevice(std::string device, bool is_game_specific = false);
diff --git a/src/core/libraries/audio/audioout.cpp b/src/core/libraries/audio/audioout.cpp
index 78d77ccf0..6f026ab0b 100644
--- a/src/core/libraries/audio/audioout.cpp
+++ b/src/core/libraries/audio/audioout.cpp
@@ -208,7 +208,7 @@ int PS4_SYSV_ABI sceAudioOutGetPortState(s32 handle, OrbisAudioOutPortState* sta
             state->channel = port.format_info.num_channels > 2 ? 2 : port.format_info.num_channels;
             break;
         case OrbisAudioOutPort::Personal:
-        case OrbisAudioOutPort::Padspk:
+        case OrbisAudioOutPort::PadSpk:
             state->output = 4;
             state->channel = 1;
             break;
@@ -328,7 +328,7 @@ s32 PS4_SYSV_ABI sceAudioOutOpen(UserService::OrbisUserServiceUserId user_id,
         LOG_ERROR(Lib_AudioOut, "Audio out not initialized");
         return ORBIS_AUDIO_OUT_ERROR_NOT_INIT;
     }
-    if ((port_type < OrbisAudioOutPort::Main || port_type > OrbisAudioOutPort::Padspk) &&
+    if ((port_type < OrbisAudioOutPort::Main || port_type > OrbisAudioOutPort::PadSpk) &&
         (port_type != OrbisAudioOutPort::Audio3d && port_type != OrbisAudioOutPort::Aux)) {
         LOG_ERROR(Lib_AudioOut, "Invalid port type");
         return ORBIS_AUDIO_OUT_ERROR_INVALID_PORT_TYPE;
diff --git a/src/core/libraries/audio/audioout.h b/src/core/libraries/audio/audioout.h
index 6d3a6399b..c993582d3 100644
--- a/src/core/libraries/audio/audioout.h
+++ b/src/core/libraries/audio/audioout.h
@@ -25,7 +25,7 @@ enum class OrbisAudioOutPort {
     Bgm = 1,
     Voice = 2,
     Personal = 3,
-    Padspk = 4,
+    PadSpk = 4,
     Audio3d = 126,
     Aux = 127,
 };
diff --git a/src/core/libraries/audio/sdl_audio.cpp b/src/core/libraries/audio/sdl_audio.cpp
index 06ebebe7b..46dd33d73 100644
--- a/src/core/libraries/audio/sdl_audio.cpp
+++ b/src/core/libraries/audio/sdl_audio.cpp
@@ -1,15 +1,17 @@
 // SPDX-FileCopyrightText: Copyright 2024 shadPS4 Emulator Project
 // SPDX-License-Identifier: GPL-2.0-or-later
 
+#include <algorithm>
 #include <thread>
 #include <SDL3/SDL_audio.h>
 #include <SDL3/SDL_hints.h>
-#include <common/config.h>
 
+#include "common/config.h"
 #include "common/logging/log.h"
 #include "core/libraries/audio/audioout.h"
 #include "core/libraries/audio/audioout_backend.h"
 
+#define SDL_INVALID_AUDIODEVICEID 0 // Defined in SDL_audio.h but not made a macro
 namespace Libraries::AudioOut {
 
 class SDLPortBackend : public PortBackend {
@@ -21,8 +23,42 @@ public:
             .channels = port.format_info.num_channels,
             .freq = static_cast<int>(port.sample_rate),
         };
-        stream =
-            SDL_OpenAudioDeviceStream(SDL_AUDIO_DEVICE_DEFAULT_PLAYBACK, &fmt, nullptr, nullptr);
+
+        // Determine port type
+        std::string port_name = port.type == OrbisAudioOutPort::PadSpk
+                                    ? Config::getPadSpkOutputDevice()
+                                    : Config::getMainOutputDevice();
+        SDL_AudioDeviceID dev_id = SDL_INVALID_AUDIODEVICEID;
+        if (port_name == "None") {
+            stream = nullptr;
+            return;
+        } else if (port_name == "Default Device") {
+            dev_id = SDL_AUDIO_DEVICE_DEFAULT_PLAYBACK;
+        } else {
+            try {
+                SDL_AudioDeviceID* dev_array = SDL_GetAudioPlaybackDevices(nullptr);
+                for (; dev_array != 0;) {
+                    std::string dev_name(SDL_GetAudioDeviceName(*dev_array));
+                    if (dev_name == port_name) {
+                        dev_id = *dev_array;
+                        break;
+                    } else {
+                        dev_array++;
+                    }
+                }
+                if (dev_id == SDL_INVALID_AUDIODEVICEID) {
+                    LOG_WARNING(Lib_AudioOut, "Audio device not found: {}", port_name);
+                    dev_id = SDL_AUDIO_DEVICE_DEFAULT_PLAYBACK;
+                }
+            } catch (const std::exception& e) {
+                LOG_ERROR(Lib_AudioOut, "Invalid audio output device: {}", port_name);
+                stream = nullptr;
+                return;
+            }
+        }
+
+        // Open the audio stream
+        stream = SDL_OpenAudioDeviceStream(dev_id, &fmt, nullptr, nullptr);
         if (stream == nullptr) {
             LOG_ERROR(Lib_AudioOut, "Failed to create SDL audio stream: {}", SDL_GetError());
             return;
diff --git a/src/qt_gui/gui_context_menus.h b/src/qt_gui/gui_context_menus.h
index f5426bd54..17053790b 100644
--- a/src/qt_gui/gui_context_menus.h
+++ b/src/qt_gui/gui_context_menus.h
@@ -408,8 +408,8 @@ public:
         }
 
         if (selected == &gameConfigConfigure || selected == &gameConfigCreate) {
-            auto settingsWindow = new SettingsDialog(m_gui_settings, m_compat_info, widget, true,
-                                                     serialStr.toStdString());
+            auto settingsWindow = new SettingsDialog(m_gui_settings, m_compat_info, widget, false,
+                                                     true, serialStr.toStdString());
             settingsWindow->exec();
         }
 
diff --git a/src/qt_gui/main_window.cpp b/src/qt_gui/main_window.cpp
index ad3ab688e..8dc21731c 100644
--- a/src/qt_gui/main_window.cpp
+++ b/src/qt_gui/main_window.cpp
@@ -407,7 +407,8 @@ void MainWindow::CreateConnects() {
             &MainWindow::StartGame);
 
     connect(ui->configureAct, &QAction::triggered, this, [this]() {
-        auto settingsDialog = new SettingsDialog(m_gui_settings, m_compat_info, this);
+        auto settingsDialog =
+            new SettingsDialog(m_gui_settings, m_compat_info, this, isGameRunning);
 
         connect(settingsDialog, &SettingsDialog::LanguageChanged, this,
                 &MainWindow::OnLanguageChanged);
@@ -441,7 +442,8 @@ void MainWindow::CreateConnects() {
     });
 
     connect(ui->settingsButton, &QPushButton::clicked, this, [this]() {
-        auto settingsDialog = new SettingsDialog(m_gui_settings, m_compat_info, this);
+        auto settingsDialog =
+            new SettingsDialog(m_gui_settings, m_compat_info, this, isGameRunning);
 
         connect(settingsDialog, &SettingsDialog::LanguageChanged, this,
                 &MainWindow::OnLanguageChanged);
diff --git a/src/qt_gui/sdl_event_wrapper.cpp b/src/qt_gui/sdl_event_wrapper.cpp
index 052321233..e160dec4e 100644
--- a/src/qt_gui/sdl_event_wrapper.cpp
+++ b/src/qt_gui/sdl_event_wrapper.cpp
@@ -41,6 +41,14 @@ bool Wrapper::ProcessEvent(SDL_Event* event) {
     case SDL_EVENT_GAMEPAD_AXIS_MOTION:
         emit SDLEvent(SDL_EVENT_GAMEPAD_AXIS_MOTION, event->gaxis.axis, event->gaxis.value);
         return true;
+    case SDL_EVENT_AUDIO_DEVICE_ADDED:
+        if (event->adevice.recording == 0)
+            emit audioDeviceChanged(true);
+        return true;
+    case SDL_EVENT_AUDIO_DEVICE_REMOVED:
+        if (event->adevice.recording == 0)
+            emit audioDeviceChanged(false);
+        return true;
     // block all other SDL events while wrapper is active
     default:
         return true;
diff --git a/src/qt_gui/sdl_event_wrapper.h b/src/qt_gui/sdl_event_wrapper.h
index 54d8c9cd1..4cb918c79 100644
--- a/src/qt_gui/sdl_event_wrapper.h
+++ b/src/qt_gui/sdl_event_wrapper.h
@@ -20,6 +20,7 @@ public:
 
 signals:
     void SDLEvent(int Type, int Input, int Value);
+    void audioDeviceChanged(bool isAdd);
 };
 
 } // namespace SdlEventWrapper
diff --git a/src/qt_gui/settings_dialog.cpp b/src/qt_gui/settings_dialog.cpp
index b551387ce..40ed5017a 100644
--- a/src/qt_gui/settings_dialog.cpp
+++ b/src/qt_gui/settings_dialog.cpp
@@ -11,6 +11,7 @@
 #include <fmt/format.h>
 
 #include "common/config.h"
+#include "common/logging/log.h"
 #include "common/scm_rev.h"
 #include "core/libraries/audio/audioout.h"
 #include "qt_gui/compatibility_info.h"
@@ -27,6 +28,7 @@
 #include "common/logging/backend.h"
 #include "common/logging/filter.h"
 #include "log_presets_dialog.h"
+#include "sdl_event_wrapper.h"
 #include "settings_dialog.h"
 #include "ui_settings_dialog.h"
 #include "video_core/renderer_vulkan/vk_instance.h"
@@ -82,18 +84,20 @@ static std::vector<QString> m_physical_devices;
 
 SettingsDialog::SettingsDialog(std::shared_ptr<gui_settings> gui_settings,
                                std::shared_ptr<CompatibilityInfoClass> m_compat_info,
-                               QWidget* parent, bool is_game_specific, std::string gsc_serial)
+                               QWidget* parent, bool is_running, bool is_specific,
+                               std::string gsc_serial)
     : QDialog(parent), ui(new Ui::SettingsDialog), m_gui_settings(std::move(gui_settings)),
-      game_specific(is_game_specific), gs_serial(gsc_serial) {
+      is_game_running(is_running), is_game_specific(is_specific), gs_serial(gsc_serial) {
 
     ui->setupUi(this);
     ui->tabWidgetSettings->setUsesScrollButtons(false);
+
     initialHeight = this->height();
 
     // Add a small clear "x" button inside the Log Filter input
     ui->logFilterLineEdit->setClearButtonEnabled(true);
 
-    if (game_specific) {
+    if (is_game_specific) {
         // Paths tab
         ui->tabWidgetSettings->setTabVisible(5, false);
         ui->chooseHomeTabComboBox->removeItem(5);
@@ -109,7 +113,7 @@ SettingsDialog::SettingsDialog(std::shared_ptr<gui_settings> gui_settings,
     }
 
     std::filesystem::path config_file =
-        game_specific
+        is_game_specific
             ? Common::FS::GetUserPath(Common::FS::PathType::CustomConfigs) / (gs_serial + ".toml")
             : Common::FS::GetUserPath(Common::FS::PathType::UserDir) / "config.toml";
 
@@ -184,6 +188,7 @@ SettingsDialog::SettingsDialog(std::shared_ptr<gui_settings> gui_settings,
     }
 
     InitializeEmulatorLanguages();
+    onAudioDeviceChange(true);
     LoadValuesFromConfig();
 
     defaultTextEdit = tr("Point your mouse at an option to display its description.");
@@ -194,17 +199,17 @@ SettingsDialog::SettingsDialog(std::shared_ptr<gui_settings> gui_settings,
     connect(ui->buttonBox, &QDialogButtonBox::clicked, this,
             [this, config_file](QAbstractButton* button) {
                 if (button == ui->buttonBox->button(QDialogButtonBox::Save)) {
-                    is_saving = true;
-                    UpdateSettings(game_specific);
-                    Config::save(config_file, game_specific);
+                    is_game_saving = true;
+                    UpdateSettings(is_game_specific);
+                    Config::save(config_file, is_game_specific);
                     QWidget::close();
                 } else if (button == ui->buttonBox->button(QDialogButtonBox::Apply)) {
-                    UpdateSettings(game_specific);
-                    Config::save(config_file, game_specific);
+                    UpdateSettings(is_game_specific);
+                    Config::save(config_file, is_game_specific);
                 } else if (button == ui->buttonBox->button(QDialogButtonBox::RestoreDefaults)) {
                     setDefaultValues();
-                    Config::setDefaultValues(game_specific);
-                    Config::save(config_file, game_specific);
+                    Config::setDefaultValues(is_game_specific);
+                    Config::save(config_file, is_game_specific);
                     LoadValuesFromConfig();
                 } else if (button == ui->buttonBox->button(QDialogButtonBox::Close)) {
                     ui->backgroundImageOpacitySlider->setValue(backgroundImageOpacitySlider_backup);
@@ -232,7 +237,7 @@ SettingsDialog::SettingsDialog(std::shared_ptr<gui_settings> gui_settings,
     {
         connect(ui->horizontalVolumeSlider, &QSlider::valueChanged, this, [this](int value) {
             VolumeSliderChange(value);
-            Config::setVolumeSlider(value, game_specific);
+            Config::setVolumeSlider(value, is_game_specific);
             Libraries::AudioOut::AdjustVol();
         });
 
@@ -526,30 +531,52 @@ SettingsDialog::SettingsDialog(std::shared_ptr<gui_settings> gui_settings,
         ui->networkConnectedCheckBox->installEventFilter(this);
         ui->psnSignInCheckBox->installEventFilter(this);
     }
+
+    SdlEventWrapper::Wrapper::wrapperActive = true;
+    if (!is_game_running) {
+        SDL_InitSubSystem(SDL_INIT_EVENTS);
+        Polling = QtConcurrent::run(&SettingsDialog::pollSDLevents, this);
+    } else {
+        SdlEventWrapper::Wrapper* DeviceEventWrapper = SdlEventWrapper::Wrapper::GetInstance();
+        QObject::connect(DeviceEventWrapper, &SdlEventWrapper::Wrapper::audioDeviceChanged, this,
+                         &SettingsDialog::onAudioDeviceChange);
+    }
 }
 
 void SettingsDialog::closeEvent(QCloseEvent* event) {
-    if (!is_saving) {
+    if (!is_game_saving) {
         ui->backgroundImageOpacitySlider->setValue(backgroundImageOpacitySlider_backup);
         emit BackgroundOpacityChanged(backgroundImageOpacitySlider_backup);
         ui->BGMVolumeSlider->setValue(bgm_volume_backup);
         BackgroundMusicPlayer::getInstance().setVolume(bgm_volume_backup);
         SyncRealTimeWidgetstoConfig();
     }
+
+    SdlEventWrapper::Wrapper::wrapperActive = false;
+    if (!is_game_running) {
+        SDL_Event quitLoop{};
+        quitLoop.type = SDL_EVENT_QUIT;
+        SDL_PushEvent(&quitLoop);
+        Polling.waitForFinished();
+
+        SDL_QuitSubSystem(SDL_INIT_EVENTS);
+        SDL_QuitSubSystem(SDL_INIT_AUDIO);
+        SDL_Quit();
+    }
     QDialog::closeEvent(event);
 }
 
 void SettingsDialog::LoadValuesFromConfig() {
     std::filesystem::path config_file;
     config_file =
-        game_specific
+        is_game_specific
             ? Common::FS::GetUserPath(Common::FS::PathType::CustomConfigs) / (gs_serial + ".toml")
             : Common::FS::GetUserPath(Common::FS::PathType::UserDir) / "config.toml";
 
     std::error_code error;
     bool is_newly_created = false;
     if (!std::filesystem::exists(config_file, error)) {
-        Config::save(config_file, game_specific);
+        Config::save(config_file, is_game_specific);
         is_newly_created = true;
     }
 
@@ -567,7 +594,7 @@ void SettingsDialog::LoadValuesFromConfig() {
                                           15, 16, 17, 7, 26, 8, 11, 20, 3, 13, 27, 10, 19, 30, 28};
 
     // Entries with no game-specific settings
-    if (!game_specific) {
+    if (!is_game_specific) {
         const auto save_data_path = Config::GetSaveDataPath();
         QString save_data_path_string;
         Common::FS::PathToQString(save_data_path_string, save_data_path);
@@ -728,6 +755,11 @@ void SettingsDialog::LoadValuesFromConfig() {
         toml::find_or<bool>(data, "Debug", "CollectShader", false));
     ui->enableLoggingCheckBox->setChecked(toml::find_or<bool>(data, "Debug", "logEnabled", true));
 
+    ui->GenAudioComboBox->setCurrentText(QString::fromStdString(
+        toml::find_or<std::string>(data, "General", "mainOutputDevice", "")));
+    ui->DsAudioComboBox->setCurrentText(QString::fromStdString(
+        toml::find_or<std::string>(data, "General", "padSpkOutputDevice", "")));
+
     std::string chooseHomeTab =
         toml::find_or<std::string>(data, "General", "chooseHomeTab", "General");
     QString translatedText = chooseHomeTabMap.key(QString::fromStdString(chooseHomeTab));
@@ -979,76 +1011,75 @@ bool SettingsDialog::eventFilter(QObject* obj, QEvent* event) {
     return QDialog::eventFilter(obj, event);
 }
 
-void SettingsDialog::UpdateSettings(bool game_specific) {
+void SettingsDialog::UpdateSettings(bool is_specific) {
     // Entries with game-specific settings, needs the game-specific arg
-    Config::setReadbacks(ui->readbacksCheckBox->isChecked(), game_specific);
-    Config::setReadbackLinearImages(ui->readbackLinearImagesCheckBox->isChecked(), game_specific);
-    Config::setDirectMemoryAccess(ui->dmaCheckBox->isChecked(), game_specific);
-    Config::setDevKitConsole(ui->devkitCheckBox->isChecked(), game_specific);
-    Config::setNeoMode(ui->neoCheckBox->isChecked(), game_specific);
-    Config::setConnectedToNetwork(ui->networkConnectedCheckBox->isChecked(), game_specific);
-    Config::setPSNSignedIn(ui->psnSignInCheckBox->isChecked(), game_specific);
+    Config::setReadbacks(ui->readbacksCheckBox->isChecked(), is_specific);
+    Config::setReadbackLinearImages(ui->readbackLinearImagesCheckBox->isChecked(), is_specific);
+    Config::setDirectMemoryAccess(ui->dmaCheckBox->isChecked(), is_specific);
+    Config::setDevKitConsole(ui->devkitCheckBox->isChecked(), is_specific);
+    Config::setNeoMode(ui->neoCheckBox->isChecked(), is_specific);
+    Config::setConnectedToNetwork(ui->networkConnectedCheckBox->isChecked(), is_specific);
+    Config::setPSNSignedIn(ui->psnSignInCheckBox->isChecked(), is_specific);
 
     Config::setIsFullscreen(
-        screenModeMap.value(ui->displayModeComboBox->currentText()) != "Windowed", game_specific);
+        screenModeMap.value(ui->displayModeComboBox->currentText()) != "Windowed", is_specific);
     Config::setFullscreenMode(
-        screenModeMap.value(ui->displayModeComboBox->currentText()).toStdString(), game_specific);
+        screenModeMap.value(ui->displayModeComboBox->currentText()).toStdString(), is_specific);
     Config::setPresentMode(
-        presentModeMap.value(ui->presentModeComboBox->currentText()).toStdString(), game_specific);
-    Config::setIsMotionControlsEnabled(ui->motionControlsCheckBox->isChecked(), game_specific);
+        presentModeMap.value(ui->presentModeComboBox->currentText()).toStdString(), is_specific);
+    Config::setIsMotionControlsEnabled(ui->motionControlsCheckBox->isChecked(), is_specific);
     Config::setBackgroundControllerInput(ui->backgroundControllerCheckBox->isChecked(),
-                                         game_specific);
-    Config::setisTrophyPopupDisabled(ui->disableTrophycheckBox->isChecked(), game_specific);
-    Config::setTrophyNotificationDuration(ui->popUpDurationSpinBox->value(), game_specific);
+                                         is_specific);
+    Config::setisTrophyPopupDisabled(ui->disableTrophycheckBox->isChecked(), is_specific);
+    Config::setTrophyNotificationDuration(ui->popUpDurationSpinBox->value(), is_specific);
 
     if (ui->radioButton_Top->isChecked()) {
-        Config::setSideTrophy("top", game_specific);
+        Config::setSideTrophy("top", is_specific);
     } else if (ui->radioButton_Left->isChecked()) {
-        Config::setSideTrophy("left", game_specific);
+        Config::setSideTrophy("left", is_specific);
     } else if (ui->radioButton_Right->isChecked()) {
-        Config::setSideTrophy("right", game_specific);
+        Config::setSideTrophy("right", is_specific);
     } else if (ui->radioButton_Bottom->isChecked()) {
-        Config::setSideTrophy("bottom", game_specific);
+        Config::setSideTrophy("bottom", is_specific);
     }
 
-    Config::setLoggingEnabled(ui->enableLoggingCheckBox->isChecked(), game_specific);
-    Config::setAllowHDR(ui->enableHDRCheckBox->isChecked(), game_specific);
+    Config::setLoggingEnabled(ui->enableLoggingCheckBox->isChecked(), is_specific);
+    Config::setAllowHDR(ui->enableHDRCheckBox->isChecked(), is_specific);
     Config::setLogType(logTypeMap.value(ui->logTypeComboBox->currentText()).toStdString(),
-                       game_specific);
-    Config::setMicDevice(ui->micComboBox->currentData().toString().toStdString(), game_specific);
-    Config::setLogFilter(ui->logFilterLineEdit->text().toStdString(), game_specific);
-    Config::setUserName(ui->userNameLineEdit->text().toStdString(), game_specific);
-    Config::setCursorState(ui->hideCursorComboBox->currentIndex(), game_specific);
-    Config::setCursorHideTimeout(ui->hideCursorComboBox->currentIndex(), game_specific);
-    Config::setGpuId(ui->graphicsAdapterBox->currentIndex() - 1, game_specific);
-    Config::setVolumeSlider(ui->horizontalVolumeSlider->value(), game_specific);
-    Config::setLanguage(languageIndexes[ui->consoleLanguageComboBox->currentIndex()],
-                        game_specific);
-    Config::setWindowWidth(ui->widthSpinBox->value(), game_specific);
-    Config::setWindowHeight(ui->heightSpinBox->value(), game_specific);
-    Config::setVblankFreq(ui->vblankSpinBox->value(), game_specific);
-    Config::setDumpShaders(ui->dumpShadersCheckBox->isChecked(), game_specific);
-    Config::setNullGpu(ui->nullGpuCheckBox->isChecked(), game_specific);
-    Config::setFsrEnabled(ui->FSRCheckBox->isChecked(), game_specific);
-    Config::setRcasEnabled(ui->RCASCheckBox->isChecked(), game_specific);
-    Config::setRcasAttenuation(ui->RCASSlider->value(), game_specific);
-    Config::setShowSplash(ui->showSplashCheckBox->isChecked(), game_specific);
-    Config::setDebugDump(ui->debugDump->isChecked(), game_specific);
-    Config::setSeparateLogFilesEnabled(ui->separateLogFilesCheckbox->isChecked(), game_specific);
-    Config::setVkValidation(ui->vkValidationCheckBox->isChecked(), game_specific);
-    Config::setVkSyncValidation(ui->vkSyncValidationCheckBox->isChecked(), game_specific);
-    Config::setRdocEnabled(ui->rdocCheckBox->isChecked(), game_specific);
-    Config::setVkHostMarkersEnabled(ui->hostMarkersCheckBox->isChecked(), game_specific);
-    Config::setVkGuestMarkersEnabled(ui->guestMarkersCheckBox->isChecked(), game_specific);
-    Config::setVkCrashDiagnosticEnabled(ui->crashDiagnosticsCheckBox->isChecked(), game_specific);
-    Config::setCollectShaderForDebug(ui->collectShaderCheckBox->isChecked(), game_specific);
-    Config::setCopyGPUCmdBuffers(ui->copyGPUBuffersCheckBox->isChecked(), game_specific);
+                       is_specific);
+    Config::setMicDevice(ui->micComboBox->currentData().toString().toStdString(), is_specific);
+    Config::setLogFilter(ui->logFilterLineEdit->text().toStdString(), is_specific);
+    Config::setUserName(ui->userNameLineEdit->text().toStdString(), is_specific);
+    Config::setCursorState(ui->hideCursorComboBox->currentIndex(), is_specific);
+    Config::setCursorHideTimeout(ui->hideCursorComboBox->currentIndex(), is_specific);
+    Config::setGpuId(ui->graphicsAdapterBox->currentIndex() - 1, is_specific);
+    Config::setVolumeSlider(ui->horizontalVolumeSlider->value(), is_specific);
+    Config::setLanguage(languageIndexes[ui->consoleLanguageComboBox->currentIndex()], is_specific);
+    Config::setWindowWidth(ui->widthSpinBox->value(), is_specific);
+    Config::setWindowHeight(ui->heightSpinBox->value(), is_specific);
+    Config::setVblankFreq(ui->vblankSpinBox->value(), is_specific);
+    Config::setDumpShaders(ui->dumpShadersCheckBox->isChecked(), is_specific);
+    Config::setNullGpu(ui->nullGpuCheckBox->isChecked(), is_specific);
+    Config::setFsrEnabled(ui->FSRCheckBox->isChecked(), is_specific);
+    Config::setRcasEnabled(ui->RCASCheckBox->isChecked(), is_specific);
+    Config::setRcasAttenuation(ui->RCASSlider->value(), is_specific);
+    Config::setShowSplash(ui->showSplashCheckBox->isChecked(), is_specific);
+    Config::setDebugDump(ui->debugDump->isChecked(), is_specific);
+    Config::setSeparateLogFilesEnabled(ui->separateLogFilesCheckbox->isChecked(), is_specific);
+    Config::setVkValidation(ui->vkValidationCheckBox->isChecked(), is_specific);
+    Config::setVkSyncValidation(ui->vkSyncValidationCheckBox->isChecked(), is_specific);
+    Config::setRdocEnabled(ui->rdocCheckBox->isChecked(), is_specific);
+    Config::setVkHostMarkersEnabled(ui->hostMarkersCheckBox->isChecked(), is_specific);
+    Config::setVkGuestMarkersEnabled(ui->guestMarkersCheckBox->isChecked(), is_specific);
+    Config::setVkCrashDiagnosticEnabled(ui->crashDiagnosticsCheckBox->isChecked(), is_specific);
+    Config::setCollectShaderForDebug(ui->collectShaderCheckBox->isChecked(), is_specific);
+    Config::setCopyGPUCmdBuffers(ui->copyGPUBuffersCheckBox->isChecked(), is_specific);
     Config::setChooseHomeTab(
         chooseHomeTabMap.value(ui->chooseHomeTabComboBox->currentText()).toStdString(),
-        game_specific);
+        is_specific);
 
     // Entries with no game-specific settings
-    if (!game_specific) {
+    if (!is_specific) {
         std::vector<Config::GameInstallDir> dirs_with_states;
         for (int i = 0; i < ui->gameFoldersListWidget->count(); i++) {
             QListWidgetItem* item = ui->gameFoldersListWidget->item(i);
@@ -1096,7 +1127,7 @@ void SettingsDialog::SyncRealTimeWidgetstoConfig() {
     std::filesystem::path userdir = Common::FS::GetUserPath(Common::FS::PathType::UserDir);
     const toml::value data = toml::parse(userdir / "config.toml");
 
-    if (!game_specific) {
+    if (!is_game_specific) {
         ui->gameFoldersListWidget->clear();
         if (data.contains("GUI")) {
             const toml::value& gui = data.at("GUI");
@@ -1137,7 +1168,7 @@ void SettingsDialog::SyncRealTimeWidgetstoConfig() {
     }
 
     toml::value gs_data;
-    game_specific
+    is_game_specific
         ? gs_data = toml::parse(Common::FS::GetUserPath(Common::FS::PathType::CustomConfigs) /
                                 (gs_serial + ".toml"))
         : gs_data = data;
@@ -1147,8 +1178,8 @@ void SettingsDialog::SyncRealTimeWidgetstoConfig() {
 
     // Since config::set can be called for volume slider (connected to the widget) outside the save
     // function, need to null it out if GS GUI is closed without saving
-    game_specific ? Config::resetGameSpecificValue("volumeSlider")
-                  : Config::setVolumeSlider(sliderValue);
+    is_game_specific ? Config::resetGameSpecificValue("volumeSlider")
+                     : Config::setVolumeSlider(sliderValue);
 
     if (presenter) {
         presenter->GetFsrSettingsRef().enable =
@@ -1161,7 +1192,7 @@ void SettingsDialog::SyncRealTimeWidgetstoConfig() {
 }
 
 void SettingsDialog::setDefaultValues() {
-    if (!game_specific) {
+    if (!is_game_specific) {
         m_gui_settings->SetValue(gui::gl_showBackgroundImage, true);
         m_gui_settings->SetValue(gui::gl_backgroundImageOpacity, 50);
         m_gui_settings->SetValue(gui::gl_playBackgroundMusic, false);
@@ -1176,3 +1207,59 @@ void SettingsDialog::setDefaultValues() {
         m_gui_settings->SetValue(gui::gen_guiLanguage, "en_US");
     }
 }
+
+void SettingsDialog::pollSDLevents() {
+    SDL_Event event;
+    while (SdlEventWrapper::Wrapper::wrapperActive) {
+
+        if (!SDL_WaitEvent(&event)) {
+            return;
+        }
+
+        if (event.type == SDL_EVENT_QUIT) {
+            return;
+        }
+
+        if (event.type == SDL_EVENT_AUDIO_DEVICE_ADDED) {
+            onAudioDeviceChange(true);
+        }
+
+        if (event.type == SDL_EVENT_AUDIO_DEVICE_REMOVED) {
+            onAudioDeviceChange(false);
+        }
+    }
+}
+
+void SettingsDialog::onAudioDeviceChange(bool isAdd) {
+    ui->GenAudioComboBox->clear();
+    ui->DsAudioComboBox->clear();
+
+    // prevent device list from refreshing too fast when game not running
+    if (!is_game_running && isAdd == false)
+        QThread::msleep(100);
+
+    int deviceCount;
+    QStringList deviceList;
+    SDL_AudioDeviceID* devices = SDL_GetAudioPlaybackDevices(&deviceCount);
+
+    if (!devices) {
+        LOG_ERROR(Lib_AudioOut, "Unable to retrieve audio device list {}", SDL_GetError());
+        return;
+    }
+
+    for (int i = 0; i < deviceCount; ++i) {
+        const char* name = SDL_GetAudioDeviceName(devices[i]);
+        std::string name_string = std::string(name);
+        deviceList.append(QString::fromStdString(name_string));
+    }
+
+    ui->GenAudioComboBox->addItem(tr("Default Device"), "Default Device");
+    ui->GenAudioComboBox->addItems(deviceList);
+    ui->GenAudioComboBox->setCurrentText(QString::fromStdString(Config::getMainOutputDevice()));
+
+    ui->DsAudioComboBox->addItem(tr("Default Device"), "Default Device");
+    ui->DsAudioComboBox->addItems(deviceList);
+    ui->DsAudioComboBox->setCurrentText(QString::fromStdString(Config::getPadSpkOutputDevice()));
+
+    SDL_free(devices);
+}
diff --git a/src/qt_gui/settings_dialog.h b/src/qt_gui/settings_dialog.h
index ace401258..25ea1507e 100644
--- a/src/qt_gui/settings_dialog.h
+++ b/src/qt_gui/settings_dialog.h
@@ -23,8 +23,8 @@ class SettingsDialog : public QDialog {
 public:
     explicit SettingsDialog(std::shared_ptr<gui_settings> gui_settings,
                             std::shared_ptr<CompatibilityInfoClass> m_compat_info,
-                            QWidget* parent = nullptr, bool is_game_specific = false,
-                            std::string gsc_serial = "");
+                            QWidget* parent = nullptr, bool is_game_running = false,
+                            bool is_game_specific = false, std::string gsc_serial = "");
     ~SettingsDialog();
 
     bool eventFilter(QObject* obj, QEvent* event) override;
@@ -47,6 +47,8 @@ private:
     void closeEvent(QCloseEvent* event) override;
     void setDefaultValues();
     void VolumeSliderChange(int value);
+    void onAudioDeviceChange(bool isAdd);
+    void pollSDLevents();
 
     std::unique_ptr<Ui::SettingsDialog> ui;
 
@@ -55,9 +57,13 @@ private:
     QString defaultTextEdit;
 
     int initialHeight;
-    bool is_saving = false;
-    bool game_specific;
+
     std::string gs_serial;
 
+    bool is_game_running = false;
+    bool is_game_specific = false;
+    bool is_game_saving = false;
+
     std::shared_ptr<gui_settings> m_gui_settings;
+    QFuture<void> Polling;
 };
diff --git a/src/qt_gui/settings_dialog.ui b/src/qt_gui/settings_dialog.ui
index c80335c40..bff53a737 100644
--- a/src/qt_gui/settings_dialog.ui
+++ b/src/qt_gui/settings_dialog.ui
@@ -77,7 +77,7 @@
          <x>0</x>
          <y>0</y>
          <width>946</width>
-         <height>501</height>
+         <height>536</height>
         </rect>
        </property>
        <layout class="QVBoxLayout" name="generalTabVLayout" stretch="0">
@@ -381,6 +381,30 @@
             </item>
            </layout>
           </item>
+          <item row="1" column="0">
+           <widget class="QGroupBox" name="GenAudioGroupBox">
+            <property name="title">
+             <string>Audio Device (general)</string>
+            </property>
+            <layout class="QVBoxLayout" name="verticalLayout_8">
+             <item>
+              <widget class="QComboBox" name="GenAudioComboBox"/>
+             </item>
+            </layout>
+           </widget>
+          </item>
+          <item row="2" column="0">
+           <widget class="QGroupBox" name="DsSpeakerGroupBox">
+            <property name="title">
+             <string>Audio Device (DS4 speaker)</string>
+            </property>
+            <layout class="QVBoxLayout" name="verticalLayout_9">
+             <item>
+              <widget class="QComboBox" name="DsAudioComboBox"/>
+             </item>
+            </layout>
+           </widget>
+          </item>
          </layout>
         </item>
        </layout>
@@ -1010,7 +1034,7 @@
          <x>0</x>
          <y>0</y>
          <width>946</width>
-         <height>501</height>
+         <height>536</height>
         </rect>
        </property>
        <layout class="QVBoxLayout" name="graphicsTabVLayout" stretch="0,0">
@@ -1417,7 +1441,7 @@
          <x>0</x>
          <y>0</y>
          <width>946</width>
-         <height>501</height>
+         <height>536</height>
         </rect>
        </property>
        <layout class="QVBoxLayout" name="userTabVLayout" stretch="0,0,1">
@@ -1632,7 +1656,7 @@
          <x>0</x>
          <y>0</y>
          <width>946</width>
-         <height>501</height>
+         <height>536</height>
         </rect>
        </property>
        <layout class="QVBoxLayout" name="inputTabVLayout" stretch="0,0,0">
@@ -1918,7 +1942,7 @@
          <x>0</x>
          <y>0</y>
          <width>946</width>
-         <height>501</height>
+         <height>536</height>
         </rect>
        </property>
        <layout class="QVBoxLayout" name="pathsTabLayout">
@@ -2087,7 +2111,7 @@
          <x>0</x>
          <y>0</y>
          <width>946</width>
-         <height>299</height>
+         <height>536</height>
         </rect>
        </property>
        <property name="sizePolicy">