diff --git a/dist-raw/runmain-hack.js b/dist-raw/runmain-hack.js
new file mode 100644
index 000000000..6c0688e14
--- /dev/null
+++ b/dist-raw/runmain-hack.js
@@ -0,0 +1,9 @@
+const {pathToFileURL} = require('url');
+
+// Hack to avoid Module.runMain on node 18.6.0
+// Keeping it simple for now, isolated in this file.
+// Could theoretically probe `getFormat` impl to determine if `import()` or `Module._load()` is best
+// Note that I attempted a try-catch around `Module._load`, but it poisons some sort of cache such that subsequent `import()` is impossible.
+exports.run = function(entryPointPath) {
+  import(pathToFileURL(entryPointPath));
+}
diff --git a/src/bin.ts b/src/bin.ts
index fb3208c48..f470a2c83 100644
--- a/src/bin.ts
+++ b/src/bin.ts
@@ -639,7 +639,15 @@ function phase4(payload: BootstrapState) {
 
   // Execute the main contents (either eval, script or piped).
   if (executeEntrypoint) {
-    Module.runMain();
+    if (
+      payload.isInChildProcess &&
+      versionGteLt(process.versions.node, '18.6.0')
+    ) {
+      // HACK workaround node regression
+      require('../dist-raw/runmain-hack.js').run(entryPointPath);
+    } else {
+      Module.runMain();
+    }
   } else {
     // Note: eval and repl may both run, but never with stdin.
     // If stdin runs, eval and repl will not.