diff --git a/setup.py b/setup.py
index e5ffb1ae..b205385c 100755
--- a/setup.py
+++ b/setup.py
@@ -159,6 +159,17 @@ def get_compiler_settings(version_str):
             sys.argv.remove('--windbg')
             settings['extra_compile_args'].extend('/Od /Ge /GS /GZ /RTC1 /Wp64 /Yd'.split())
 
+        # Visual Studio 2019 defaults to using __CxxFrameHandler4 which is in
+        # VCRUNTIME140_1.DLL which Python 3.7 and earlier are not linked to.  This requirement
+        # means pyodbc will not load unless the user has installed a UCRT update.  Turn this
+        # off to match the Python 3.7 settings.
+        #
+        # Unfortunately these are *hidden* settings.  I guess we should be glad they actually
+        # made the settings.
+        # https://lectem.github.io/msvc/reverse-engineering/build/2019/01/21/MSVC-hidden-flags.html
+        settings['extra_compile_args'].append('/d2FH4-')
+        settings['extra_link_args'].append('/d2:-FH4-')
+
         settings['libraries'].append('odbc32')
         settings['libraries'].append('advapi32')