diff --git a/api/incubator/src/main/java/io/opentelemetry/api/incubator/propagation/EnvironmentGetter.java b/api/incubator/src/main/java/io/opentelemetry/api/incubator/propagation/EnvironmentGetter.java
index 5d379a6794b..204bc74cfc7 100644
--- a/api/incubator/src/main/java/io/opentelemetry/api/incubator/propagation/EnvironmentGetter.java
+++ b/api/incubator/src/main/java/io/opentelemetry/api/incubator/propagation/EnvironmentGetter.java
@@ -31,8 +31,11 @@
  * <p>This getter automatically sanitizes keys to match environment variable naming conventions:
  *
  * <ul>
- *   <li>Converts keys to uppercase (e.g., {@code traceparent} becomes {@code TRACEPARENT})
- *   <li>Replaces {@code .} and {@code -} with underscores
+ *   <li>Replaces an empty key with a single underscore ({@code _})
+ *   <li>Converts ASCII letters to uppercase (e.g., {@code traceparent} becomes {@code TRACEPARENT})
+ *   <li>Replaces every character that is not an ASCII letter, digit, or underscore with an
+ *       underscore
+ *   <li>Prepends an underscore if the result would otherwise start with an ASCII digit
  * </ul>
  *
  * <p>Values are validated to contain only characters valid in HTTP header fields per <a
diff --git a/api/incubator/src/main/java/io/opentelemetry/api/incubator/propagation/EnvironmentSetter.java b/api/incubator/src/main/java/io/opentelemetry/api/incubator/propagation/EnvironmentSetter.java
index ba4f3638a6a..d56740e515a 100644
--- a/api/incubator/src/main/java/io/opentelemetry/api/incubator/propagation/EnvironmentSetter.java
+++ b/api/incubator/src/main/java/io/opentelemetry/api/incubator/propagation/EnvironmentSetter.java
@@ -27,6 +27,7 @@
  * conventions:
  *
  * <ul>
+ *   <li>An empty key is replaced with a single underscore ({@code _})
  *   <li>ASCII letters are converted to uppercase
  *   <li>Any character that is not an ASCII letter, digit, or underscore is replaced with an
  *       underscore
@@ -92,6 +93,7 @@ static boolean isNormalizedKey(String key) {
    * Normalizes a key to be a valid environment variable name.
    *
    * <ul>
+   *   <li>An empty key is replaced with a single underscore ({@code _})
    *   <li>ASCII letters are converted to uppercase
    *   <li>Any character that is not an ASCII letter, digit, or underscore is replaced with an
    *       underscore (including {@code .}, {@code -}, whitespace, and control characters)
@@ -102,6 +104,9 @@ static String normalizeKey(String key) {
     if (isNormalizedKey(key)) {
       return key;
     }
+    if (key.isEmpty()) {
+      return "_";
+    }
     StringBuilder sb = new StringBuilder(key.length() + 1);
     for (int i = 0; i < key.length(); i++) {
       char ch = key.charAt(i);
diff --git a/api/incubator/src/test/java/io/opentelemetry/api/incubator/propagation/EnvironmentGetterTest.java b/api/incubator/src/test/java/io/opentelemetry/api/incubator/propagation/EnvironmentGetterTest.java
index 7a2948e0eda..9336d8ea8dd 100644
--- a/api/incubator/src/test/java/io/opentelemetry/api/incubator/propagation/EnvironmentGetterTest.java
+++ b/api/incubator/src/test/java/io/opentelemetry/api/incubator/propagation/EnvironmentGetterTest.java
@@ -40,12 +40,15 @@ void get_normalization() {
     // Carrier entries are expected to have normalized keys (i.e. set via EnvironmentSetter).
     carrier.put("OTEL_TRACE_ID", "val1");
     carrier.put("OTEL_BAGGAGE_KEY", "val2");
+    carrier.put("_", "val3");
     // Carrier entry with an unnormalized key is not reachable via get().
-    carrier.put("otel-unreachable-key", "val3");
+    carrier.put("", "val4");
+    carrier.put("otel-unreachable-key", "val5");
 
     // Lookup keys are normalized before the carrier map is consulted.
     assertThat(EnvironmentGetter.getInstance().get(carrier, "otel.trace.id")).isEqualTo("val1");
     assertThat(EnvironmentGetter.getInstance().get(carrier, "otel-baggage-key")).isEqualTo("val2");
+    assertThat(EnvironmentGetter.getInstance().get(carrier, "")).isEqualTo("val3");
     // Carrier entries with unnormalized keys are not enumerated.
     assertThat(EnvironmentGetter.getInstance().get(carrier, "otel-unreachable-key")).isNull();
   }
@@ -60,12 +63,15 @@ void get_null() {
   @SuppressLogger(EnvironmentGetter.class)
   void keys_onlyNormalizedKeysIncluded() {
     Map<String, String> carrier = new HashMap<>();
+    carrier.put("", "V0");
     carrier.put("otel.trace.id", "V1");
     carrier.put("otel-baggage-key", "V2");
     carrier.put("OTEL_FOO", "V3");
+    carrier.put("_", "V4");
 
     // Non-normalized keys are excluded; only already-normalized keys are returned.
-    assertThat(EnvironmentGetter.getInstance().keys(carrier)).containsExactlyInAnyOrder("OTEL_FOO");
+    assertThat(EnvironmentGetter.getInstance().keys(carrier))
+        .containsExactlyInAnyOrder("OTEL_FOO", "_");
     for (String key : EnvironmentGetter.getInstance().keys(carrier)) {
       assertThat(EnvironmentGetter.getInstance().get(carrier, key)).isNotNull();
     }
diff --git a/api/incubator/src/test/java/io/opentelemetry/api/incubator/propagation/EnvironmentSetterTest.java b/api/incubator/src/test/java/io/opentelemetry/api/incubator/propagation/EnvironmentSetterTest.java
index f0d2b2e73ee..e4c40b8a282 100644
--- a/api/incubator/src/test/java/io/opentelemetry/api/incubator/propagation/EnvironmentSetterTest.java
+++ b/api/incubator/src/test/java/io/opentelemetry/api/incubator/propagation/EnvironmentSetterTest.java
@@ -34,9 +34,11 @@ void set_sanitization() {
     Map<String, String> carrier = new HashMap<>();
     EnvironmentSetter.getInstance().set(carrier, "otel.trace.id", "val1");
     EnvironmentSetter.getInstance().set(carrier, "otel-baggage-key", "val2");
+    EnvironmentSetter.getInstance().set(carrier, "", "val3");
 
     assertThat(carrier).containsEntry("OTEL_TRACE_ID", "val1");
     assertThat(carrier).containsEntry("OTEL_BAGGAGE_KEY", "val2");
+    assertThat(carrier).containsEntry("_", "val3");
   }
 
   @Test
@@ -76,6 +78,7 @@ static Stream<Arguments> isNormalizedKeyCases() {
     return Stream.of(
         Arguments.argumentSet("uppercase letters", "TRACEPARENT", true),
         Arguments.argumentSet("uppercase with underscores", "OTEL_TRACE_ID", true),
+        Arguments.argumentSet("single underscore", "_", true),
         Arguments.argumentSet("single letter", "A", true),
         Arguments.argumentSet("letter then digit", "A0", true),
         Arguments.argumentSet("mixed uppercase digits underscores", "A_B_0", true),