diff --git a/lib/ruby_indexer/lib/ruby_indexer/index.rb b/lib/ruby_indexer/lib/ruby_indexer/index.rb
index 3c60163e3..aaa46f12b 100644
--- a/lib/ruby_indexer/lib/ruby_indexer/index.rb
+++ b/lib/ruby_indexer/lib/ruby_indexer/index.rb
@@ -48,6 +48,8 @@ def initialize
       )
 
       @configuration = T.let(RubyIndexer::Configuration.new, Configuration)
+
+      @initial_indexing_complete = T.let(false, T::Boolean)
     end
 
     # Register an included `hook` that will be executed when `module_name` is included into any namespace
@@ -56,8 +58,8 @@ def register_included_hook(module_name, &hook)
       (@included_hooks[module_name] ||= []) << hook
     end
 
-    sig { params(uri: URI::Generic).void }
-    def delete(uri)
+    sig { params(uri: URI::Generic, skip_require_tree: T::Boolean).void }
+    def delete(uri, skip_require_tree: false)
       key = uri.to_s
       # For each constant discovered in `path`, delete the associated entry from the index. If there are no entries
       # left, delete the constant from the index.
@@ -80,6 +82,7 @@ def delete(uri)
       end
 
       @uris_to_entries.delete(key)
+      return if skip_require_tree
 
       require_path = uri.require_path
       @require_paths_tree.delete(require_path) if require_path
@@ -358,11 +361,13 @@ def index_all(uris: @configuration.indexable_uris, &block)
       # existing index values, meaning it may contain 'stale' entries. This check ensures that the user is aware of this
       # behavior and can take appropriate action.
       # binding.break
-      if @entries.any?
+      if @initial_indexing_complete
         raise IndexNotEmptyError,
           "The index is not empty. To prevent invalid entries, `index_all` can only be called once."
       end
 
+      @initial_indexing_complete = true
+
       RBSIndexer.new(self).index_ruby_core
       # Calculate how many paths are worth 1% of progress
       progress_step = (uris.length / 100.0).ceil
diff --git a/lib/ruby_indexer/test/index_test.rb b/lib/ruby_indexer/test/index_test.rb
index 80a5a8dc4..c79c6d2ec 100644
--- a/lib/ruby_indexer/test/index_test.rb
+++ b/lib/ruby_indexer/test/index_test.rb
@@ -2061,7 +2061,8 @@ def test_build_non_redundant_name
     end
 
     def test_prevents_multiple_calls_to_index_all
-      # For this test class, `index_all` is already called once in `setup`.
+      @index.index_all
+
       assert_raises(Index::IndexNotEmptyError) do
         @index.index_all
       end
diff --git a/lib/ruby_lsp/server.rb b/lib/ruby_lsp/server.rb
index b7b1d5770..3e90c76b1 100644
--- a/lib/ruby_lsp/server.rb
+++ b/lib/ruby_lsp/server.rb
@@ -493,6 +493,18 @@ def run_combined_requests(message)
       document_link = Requests::DocumentLink.new(uri, parse_result.comments, dispatcher)
       code_lens = Requests::CodeLens.new(@global_state, uri, dispatcher)
       inlay_hint = Requests::InlayHints.new(document, T.must(@store.features_configuration.dig(:inlayHint)), dispatcher)
+
+      # Re-index the file as it is modified. This mode of indexing updates entries only. Require path trees are only
+      # updated on save
+      @global_state.index.delete(uri, skip_require_tree: true)
+      RubyIndexer::DeclarationListener.new(
+        @global_state.index,
+        dispatcher,
+        parse_result,
+        uri,
+        collect_comments: true,
+      )
+
       dispatcher.dispatch(parse_result.value)
 
       # Store all responses retrieve in this round of visits in the cache and then return the response for the request
diff --git a/test/server_test.rb b/test/server_test.rb
index ba042c199..8af7d0ffe 100644
--- a/test/server_test.rb
+++ b/test/server_test.rb
@@ -789,6 +789,64 @@ def test_cancelling_requests_returns_expected_error_code
     assert_equal("Request 1 was cancelled", error.message)
   end
 
+  def test_unsaved_changes_are_indexed_when_computing_automatic_features
+    uri = URI("file:///foo.rb")
+    index = @server.global_state.index
+
+    # Simulate opening a file. First, send the notification to open the file with a class inside
+    @server.process_message({
+      method: "textDocument/didOpen",
+      params: {
+        textDocument: {
+          uri: uri,
+          text: +"class Foo\nend",
+          version: 1,
+          languageId: "ruby",
+        },
+      },
+    })
+    # Fire the automatic features requests to trigger indexing
+    @server.process_message({
+      id: 1,
+      method: "textDocument/documentSymbol",
+      params: { textDocument: { uri: uri } },
+    })
+
+    entries = index["Foo"]
+    assert_equal(1, entries.length)
+
+    # Modify the file without saving
+    @server.process_message({
+      method: "textDocument/didChange",
+      params: {
+        textDocument: { uri: uri, version: 2 },
+        contentChanges: [
+          { text: "  def bar\n  end\n", range: { start: { line: 1, character: 0 }, end: { line: 1, character: 0 } } },
+        ],
+      },
+    })
+
+    # Parse the document after it was modified. This occurs automatically when we receive a text document request, to
+    # avoid parsing the document multiple times, but that depends on request coming in through the STDIN pipe, which
+    # isn't reproduced here. Parsing manually matches what happens normally
+    store = @server.instance_variable_get(:@store)
+    store.get(uri).parse!
+
+    # Trigger the automatic features again
+    @server.process_message({
+      id: 2,
+      method: "textDocument/documentSymbol",
+      params: { textDocument: { uri: uri } },
+    })
+
+    # There should still only be one entry for each declaration, but we should have picked up the new ones
+    entries = index["Foo"]
+    assert_equal(1, entries.length)
+
+    entries = index["bar"]
+    assert_equal(1, entries.length)
+  end
+
   private
 
   def with_uninstalled_rubocop(&block)