diff --git a/src/bedrock_agentcore/runtime/app.py b/src/bedrock_agentcore/runtime/app.py
index dd675b54..290a16ca 100644
--- a/src/bedrock_agentcore/runtime/app.py
+++ b/src/bedrock_agentcore/runtime/app.py
@@ -530,19 +530,37 @@ def _ensure_worker_loop(self) -> asyncio.AbstractEventLoop:
             return self._worker_loop
         with self._worker_loop_lock:
             if self._worker_loop is None or not self._worker_loop.is_running():
-                self._worker_loop = asyncio.new_event_loop()
+                ready = threading.Event()
                 self._worker_thread = threading.Thread(
                     target=self._run_worker_loop,
+                    args=(ready,),
                     daemon=True,
                     name="agentcore-worker-loop",
                 )
                 self._worker_thread.start()
+                if not ready.wait(timeout=10):
+                    raise RuntimeError("agentcore-worker-loop failed to start")
         return self._worker_loop
 
-    def _run_worker_loop(self) -> None:
-        """Entry point for the worker loop background thread."""
-        asyncio.set_event_loop(self._worker_loop)
-        self._worker_loop.run_forever()
+    def _run_worker_loop(self, ready: threading.Event) -> None:
+        """Entry point for the worker loop background thread.
+
+        The event loop is created here (inside the worker thread) rather than in
+        the parent thread to avoid conflicts with OpenTelemetry's threading
+        instrumentation, which propagates context from the parent thread and can
+        cause ``RuntimeError: Cannot run the event loop while another loop is
+        running``.
+        """
+        # Clear any running-loop state that leaked from the parent thread
+        # (e.g. via OpenTelemetry's threading instrumentation context propagation).
+        # Without this, run_forever() raises RuntimeError because
+        # asyncio._get_running_loop() still returns the parent's loop.
+        asyncio._set_running_loop(None)
+        loop = asyncio.new_event_loop()
+        asyncio.set_event_loop(loop)
+        self._worker_loop = loop
+        loop.call_soon(ready.set)
+        loop.run_forever()
 
     @staticmethod
     async def _run_with_context(coro: Any, ctx: contextvars.Context) -> Any:
diff --git a/tests/bedrock_agentcore/runtime/test_app.py b/tests/bedrock_agentcore/runtime/test_app.py
index c4d37b89..bfc756a0 100644
--- a/tests/bedrock_agentcore/runtime/test_app.py
+++ b/tests/bedrock_agentcore/runtime/test_app.py
@@ -2715,3 +2715,38 @@ async def handler(payload):
         content = response.content.decode("utf-8")
         assert 'data: {"chunk": "a"}' in content
         assert 'data: {"chunk": "b"}' in content
+
+    @pytest.mark.asyncio
+    async def test_worker_loop_compatible_with_otel_threading_instrumentation(self):
+        """Worker loop starts even when a running loop leaks into the child thread.
+
+        OpenTelemetry's opentelemetry-instrumentation-threading wraps Thread.run()
+        to propagate trace context. This can leak the parent thread's running-loop
+        state into the child thread, causing:
+            RuntimeError: Cannot run the event loop while another loop is running
+
+        The fix clears leaked running-loop state at the top of _run_worker_loop.
+        """
+        app = BedrockAgentCoreApp()
+        ready = threading.Event()
+
+        def otel_simulated_target():
+            """Simulate OTEL wrapper leaking a running loop before _run_worker_loop."""
+            leak = asyncio.new_event_loop()
+            asyncio._set_running_loop(leak)
+            try:
+                app._run_worker_loop(ready)
+            finally:
+                asyncio._set_running_loop(None)
+                leak.close()
+
+        thread = threading.Thread(target=otel_simulated_target, daemon=True)
+        thread.start()
+        assert ready.wait(timeout=5), "Worker loop failed to start under OTEL-like wrapper"
+
+        assert app._worker_loop is not None
+        assert app._worker_loop.is_running()
+
+        # Verify the loop can actually execute work
+        future = asyncio.run_coroutine_threadsafe(asyncio.sleep(0, result="otel_ok"), app._worker_loop)
+        assert future.result(timeout=5) == "otel_ok"