diff --git a/async_lru/__init__.py b/async_lru/__init__.py
index 447e9cdb..aadb96e8 100644
--- a/async_lru/__init__.py
+++ b/async_lru/__init__.py
@@ -56,6 +56,8 @@ class _CacheParameters(TypedDict):
 class _CacheItem(Generic[_R]):
     fut: "asyncio.Future[_R]"
     later_call: Optional[asyncio.Handle]
+    waiters: int
+    task: "asyncio.Task[_R]"
 
     def cancel(self) -> None:
         if self.later_call is not None:
@@ -192,6 +194,15 @@ def _task_done_callback(
 
         fut.set_result(task.result())
 
+    def _handle_cancelled_error(self, key: Hashable, cache_item: "_CacheItem") -> None:
+        # Called when a waiter is cancelled.
+        # If this is the last waiter and the underlying task is not done,
+        # cancel the underlying task and remove the cache entry.
+        if cache_item.waiters == 1 and not cache_item.task.done():
+            cache_item.cancel()  # Cancel TTL expiration
+            cache_item.task.cancel()  # Cancel the running coroutine
+            self.__cache.pop(key, None)  # Remove from cache
+
     async def __call__(self, /, *fn_args: Any, **fn_kwargs: Any) -> _R:
         if self.__closed:
             raise RuntimeError(f"alru_cache is closed for {self}")
@@ -205,8 +216,20 @@ async def __call__(self, /, *fn_args: Any, **fn_kwargs: Any) -> _R:
         if cache_item is not None:
             self._cache_hit(key)
             if not cache_item.fut.done():
-                return await asyncio.shield(cache_item.fut)
-
+                # Each logical waiter increments waiters on entry.
+                cache_item.waiters += 1
+
+                try:
+                    # All waiters await the same future.
+                    return await asyncio.shield(cache_item.fut)
+                except asyncio.CancelledError:
+                    # If a waiter is cancelled, handle possible last-waiter cleanup.
+                    self._handle_cancelled_error(key, cache_item)
+                    raise
+                finally:
+                    # Each logical waiter decrements waiters on exit (normal or cancelled).
+                    cache_item.waiters -= 1
+            # If the future is already done, just return the result.
             return cache_item.fut.result()
 
         fut = loop.create_future()
@@ -215,14 +238,22 @@ async def __call__(self, /, *fn_args: Any, **fn_kwargs: Any) -> _R:
         self.__tasks.add(task)
         task.add_done_callback(partial(self._task_done_callback, fut, key))
 
-        self.__cache[key] = _CacheItem(fut, None)
+        cache_item = _CacheItem(fut, None, 1, task)
+        self.__cache[key] = cache_item
 
         if self.__maxsize is not None and len(self.__cache) > self.__maxsize:
-            dropped_key, cache_item = self.__cache.popitem(last=False)
-            cache_item.cancel()
+            dropped_key, dropped_cache_item = self.__cache.popitem(last=False)
+            dropped_cache_item.cancel()
 
         self._cache_miss(key)
-        return await asyncio.shield(fut)
+
+        try:
+            return await asyncio.shield(fut)
+        except asyncio.CancelledError:
+            self._handle_cancelled_error(key, cache_item)
+            raise
+        finally:
+            cache_item.waiters -= 1
 
     def __get__(
         self, instance: _T, owner: Optional[Type[_T]]
diff --git a/tests/test_cancel.py b/tests/test_cancel.py
new file mode 100644
index 00000000..8dc1e962
--- /dev/null
+++ b/tests/test_cancel.py
@@ -0,0 +1,58 @@
+import asyncio
+
+import pytest
+
+from async_lru import alru_cache
+
+
+@pytest.mark.parametrize("num_to_cancel", [0, 1, 2, 3])
+async def test_cancel(num_to_cancel: int) -> None:
+    cache_item_task_finished = False
+
+    @alru_cache
+    async def coro(val: int) -> int:
+        # I am a long running coro function
+        nonlocal cache_item_task_finished
+        await asyncio.sleep(2)
+        cache_item_task_finished = True
+        return val
+
+    # create 3 tasks for the cached function using the same key
+    tasks = [asyncio.create_task(coro(1)) for _ in range(3)]
+
+    # force the event loop to run once so the tasks can begin
+    await asyncio.sleep(0)
+
+    # maybe cancel some tasks
+    for i in range(num_to_cancel):
+        tasks[i].cancel()
+
+    # allow enough time for the non-cancelled tasks to complete
+    await asyncio.sleep(3)
+
+    # check state
+    assert cache_item_task_finished == (num_to_cancel < 3)
+
+
+@pytest.mark.asyncio
+async def test_cancel_single_waiter_triggers_handle_cancelled_error():
+    # This test ensures the _handle_cancelled_error path (waiters == 1) is exercised.
+    cache_item_task_finished = False
+
+    @alru_cache
+    async def coro(val: int) -> int:
+        nonlocal cache_item_task_finished
+        await asyncio.sleep(2)
+        cache_item_task_finished = True
+        return val
+
+    task = asyncio.create_task(coro(42))
+    await asyncio.sleep(0)
+    task.cancel()
+    try:
+        await task
+    except asyncio.CancelledError:
+        pass
+
+    # The underlying coroutine should be cancelled, so the flag should remain False
+    assert cache_item_task_finished is False