diff --git a/create-hook.mjs b/create-hook.mjs
index 1ca5384..362e252 100644
--- a/create-hook.mjs
+++ b/create-hook.mjs
@@ -5,7 +5,7 @@
 import { URL, fileURLToPath } from 'url'
 import { inspect } from 'util'
 import { builtinModules } from 'module'
-import { getExports } from './lib/get-exports.mjs'
+import { getModuleExports } from './lib/get-exports.mjs'
 import { RESOLVE, driveSync, driveAsync } from './lib/io.mjs'
 import { supportsSyncHooks } from './supports-sync-hooks.mjs'
 
@@ -204,7 +204,7 @@ function shouldExcludeExport (name, sourceUrl) {
  *
  * Written as a "sans-io" generator (see `lib/io.mjs`): instead of calling the
  * loader's resolve/load hooks directly it `yield`s `[RESOLVE, ...]` to resolve
- * star re-exports and `[LOAD, ...]` (via {@link getExports}) to read source,
+ * star re-exports and `[LOAD, ...]` (via {@link getModuleExports}) to read source,
  * and is driven by either {@link driveSync} (for
  * `module.registerHooks`) or {@link driveAsync} (for `module.register`). The
  * body is identical for both, so there is a single implementation to maintain.
@@ -228,7 +228,7 @@ function shouldExcludeExport (name, sourceUrl) {
  * for a module with no `export *`.
  */
 function * processModule ({ srcUrl, context, excludeDefault = false, depth = 0, seen }) {
-  const { exportNames, starReexports } = yield * getExports(srcUrl, context)
+  const { exportNames, starReexports } = yield * getModuleExports(srcUrl, context)
 
   // Most modules have no export star. Keep that path array-backed so it pays
   // neither merge bookkeeping nor a Map lookup for each direct export.
diff --git a/lib/get-esm-exports.mjs b/lib/get-esm-exports.mjs
index 4d2c275..8813f6c 100644
--- a/lib/get-esm-exports.mjs
+++ b/lib/get-esm-exports.mjs
@@ -49,7 +49,7 @@ export default function getEsmExports (moduleSource) {
 /**
  * Lexes ESM source code once and reports both the exported identifiers and
  * whether the source uses ESM syntax. Sharing a single `parse` lets the
- * unknown-format path in `getExports` decide between ESM and CommonJS without a
+ * unknown-format path in `getModuleExports` decide between ESM and CommonJS without a
  * second pass over the source.
  *
  * `hasModuleSyntax` is es-module-lexer's own signal: static `import`/`export`
diff --git a/lib/get-exports.mjs b/lib/get-exports.mjs
index c309079..bdaf5c6 100644
--- a/lib/get-exports.mjs
+++ b/lib/get-exports.mjs
@@ -200,7 +200,7 @@ function * getCjsExports (url, context, source) {
         continue
       }
 
-      const child = yield * getExports(newUrl, context)
+      const child = yield * getModuleExports(newUrl, context)
       for (const each of child.exportNames) {
         full.add(each)
       }
@@ -244,7 +244,7 @@ function * getCjsExports (url, context, source) {
  * operations and ultimately returns the identifiers and star re-exports of the
  * module.
  */
-export function * getExports (url, context) {
+export function * getModuleExports (url, context) {
   const cached = esmExportsCache.get(url)
   if (cached !== undefined) {
     return cached
@@ -322,3 +322,25 @@ export function * getExports (url, context) {
     throw err
   }
 }
+
+/**
+ * Preserves the iterable export result used before import-in-the-middle 3.5.0.
+ *
+ * @param {string} url A file URL string pointing to the module to inspect.
+ * @param {object} context Context object as provided by the loaders API.
+ * @returns {Generator<Array, Set<string>>}
+ */
+export function * getExports (url, context) {
+  const { exportNames, starReexports } = yield * getModuleExports(url, context)
+  const legacyExports = starReexports === undefined && exportNames instanceof Set
+    ? exportNames
+    : new Set(exportNames)
+
+  if (starReexports !== undefined) {
+    for (const { specifier } of starReexports) {
+      legacyExports.add(`* from ${specifier}`)
+    }
+  }
+
+  return legacyExports
+}
diff --git a/lib/register.js b/lib/register.js
index ff5f167..7be6526 100644
--- a/lib/register.js
+++ b/lib/register.js
@@ -4,6 +4,9 @@
 
 const importHooks = [] // TODO should this be a Set?
 const binders = new WeakMap()
+let legacySetters
+let legacyGetters
+let legacyProxyHandler
 const specifiers = new Map()
 const toHook = []
 
@@ -41,12 +44,75 @@ function defineExport (target, name, descriptor) {
 
 const proxyHandler = { defineProperty: defineExport, set: setExport }
 
+/**
+ * @param {object} target The proxy target.
+ * @param {string | symbol} name The export name.
+ * @param {unknown} value The replacement value.
+ */
+function setLegacyExport (target, name, value) {
+  const setter = legacySetters.get(target)?.[name]
+  return typeof setter === 'function' ? setter(value) : true
+}
+
+/**
+ * @param {object} target The proxy target.
+ * @param {string | symbol} name The export name.
+ */
+function getLegacyExport (target, name) {
+  if (name === Symbol.toStringTag) return 'Module'
+
+  const getter = legacyGetters.get(target)[name]
+  if (typeof getter === 'function') return getter()
+}
+
+/**
+ * @param {object} target The proxy target.
+ * @param {string | symbol} name The export name.
+ * @param {PropertyDescriptor} descriptor The replacement descriptor.
+ */
+function defineLegacyExport (target, name, descriptor) {
+  if (!('value' in descriptor)) {
+    throw new Error('Getters/setters are not supported for exports property descriptors.')
+  }
+  return setLegacyExport(target, name, descriptor.value)
+}
+
 /**
  * @param {string} name The wrapped module URL.
- * @param {ModuleBinder} binder The wrapper's binding state.
+ * @param {object} namespace The wrapper's module namespace.
+ * @param {object} set The wrapper's export setters.
+ * @param {object} get The wrapper's export getters.
  * @param {string} specifier The original import specifier.
  */
-function register (name, binder, specifier) {
+function registerLegacy (name, namespace, set, get, specifier) {
+  legacySetters ??= new WeakMap()
+  legacyGetters ??= new WeakMap()
+  legacyProxyHandler ??= {
+    defineProperty: defineLegacyExport,
+    get: getLegacyExport,
+    set: setLegacyExport
+  }
+  specifiers.set(name, specifier)
+  legacySetters.set(namespace, set)
+  legacyGetters.set(namespace, get)
+  const proxy = new Proxy(namespace, legacyProxyHandler)
+  importHooks.forEach(hook => hook(name, proxy, specifier))
+  toHook.push([name, proxy, specifier])
+}
+
+/**
+ * @param {string} name The wrapped module URL.
+ * @param {ModuleBinder | object} binder The wrapper's binding state or legacy namespace.
+ * @param {string | object} specifier The original import specifier or legacy setters.
+ * @param {object} [get] The legacy export getters.
+ * @param {string} [legacySpecifier] The legacy original import specifier.
+ */
+function register (name, binder, specifier, get, legacySpecifier) {
+  if (arguments.length === 5) {
+    registerLegacy(name, binder, specifier, get, legacySpecifier)
+    return
+  }
+
   const { namespace } = binder
   specifiers.set(name, specifier)
   binders.set(namespace, binder)
diff --git a/test/get-esm-exports/get-exports-builtin-non-enumerable.mjs b/test/get-esm-exports/get-exports-builtin-non-enumerable.mjs
index 0c1f8f0..7fc924c 100644
--- a/test/get-esm-exports/get-exports-builtin-non-enumerable.mjs
+++ b/test/get-esm-exports/get-exports-builtin-non-enumerable.mjs
@@ -24,7 +24,7 @@ const nonEnumerableNames = Object.getOwnPropertyNames(moduleValue)
 
 const io = { load: async () => ({ source: null, format: 'builtin' }) }
 
-const { exportNames } = await driveAsync(getExports(builtin, { format: 'builtin' }), io)
+const exportNames = await driveAsync(getExports(builtin, { format: 'builtin' }), io)
 
 // The whole point: non-enumerable own properties (e.g. `prototype`) that
 // Object.keys would miss must still be discovered.
diff --git a/test/get-esm-exports/get-exports-compat.mjs b/test/get-esm-exports/get-exports-compat.mjs
new file mode 100644
index 0000000..839c966
--- /dev/null
+++ b/test/get-esm-exports/get-exports-compat.mjs
@@ -0,0 +1,26 @@
+import { deepStrictEqual, strictEqual } from 'assert'
+
+import { getExports } from '../../lib/get-exports.mjs'
+import { driveAsync } from '../../lib/io.mjs'
+
+const modules = new Map([
+  ['file:///direct.mjs', 'export const direct = 1'],
+  ['file:///star.mjs', 'export const direct = 1; export * from "./dependency.mjs"']
+])
+
+const io = {
+  /**
+   * @param {string} url The module URL.
+   */
+  async load (url) {
+    return { source: modules.get(url), format: 'module' }
+  }
+}
+
+const directExports = await driveAsync(getExports('file:///direct.mjs', { format: 'module' }), io)
+strictEqual(directExports instanceof Set, true)
+deepStrictEqual([...directExports], ['direct'])
+
+const starExports = await driveAsync(getExports('file:///star.mjs', { format: 'module' }), io)
+strictEqual(starExports instanceof Set, true)
+deepStrictEqual([...starExports], ['direct', '* from ./dependency.mjs'])
diff --git a/test/low-level/register-compat.mjs b/test/low-level/register-compat.mjs
new file mode 100644
index 0000000..a553f8a
--- /dev/null
+++ b/test/low-level/register-compat.mjs
@@ -0,0 +1,52 @@
+import { createRequire } from 'module'
+import { strictEqual, throws } from 'assert'
+
+const require = createRequire(import.meta.url)
+const { importHooks, register, specifiers } = require('../../lib/register.js')
+
+let value = 42
+let legacyExports
+
+/** @param {unknown} nextValue The replacement export value. */
+function setValue (nextValue) {
+  value = nextValue
+  return true
+}
+
+function getValue () {
+  return value
+}
+
+/**
+ * @param {string} name The module URL.
+ * @param {object} exports The intercepted exports.
+ * @param {string} specifier The original import specifier.
+ */
+function onImport (name, exports, specifier) {
+  strictEqual(name, 'file:///legacy.mjs')
+  strictEqual(specifier, 'legacy')
+  legacyExports = exports
+}
+
+importHooks.push(onImport)
+try {
+  const namespace = Object.create(null, { [Symbol.toStringTag]: { value: 'Module' } })
+  namespace.foo = value
+  register('file:///legacy.mjs', namespace, { foo: setValue }, { foo: getValue }, 'legacy')
+
+  strictEqual(specifiers.get('file:///legacy.mjs'), 'legacy')
+  strictEqual(legacyExports.foo, 42)
+  strictEqual(legacyExports[Symbol.toStringTag], 'Module')
+  strictEqual(Reflect.set(legacyExports, 'foo', 43), true)
+  strictEqual(legacyExports.foo, 43)
+  strictEqual(Reflect.defineProperty(legacyExports, 'foo', { value: 44 }), true)
+  strictEqual(legacyExports.foo, 44)
+  strictEqual(Reflect.set(legacyExports, 'missing', 1), true)
+  strictEqual(legacyExports.missing, undefined)
+  throws(
+    () => Object.defineProperty(legacyExports, 'foo', { get: getValue }),
+    /Getters\/setters are not supported/
+  )
+} finally {
+  importHooks.pop()
+}