diff --git a/libpod/container_internal.go b/libpod/container_internal.go
index ca2eee1208..721d78d5ba 100644
--- a/libpod/container_internal.go
+++ b/libpod/container_internal.go
@@ -1546,6 +1546,14 @@ func (c *Container) pause() error {
 		}
 	}
 
+	if c.state.HCUnitName != "" {
+		if err := c.removeTransientFiles(context.Background(),
+			c.config.StartupHealthCheckConfig != nil && !c.state.StartupHCPassed,
+			c.state.HCUnitName); err != nil {
+			return fmt.Errorf("failed to remove HealthCheck timer: %v", err)
+		}
+	}
+
 	if err := c.ociRuntime.PauseContainer(c); err != nil {
 		// TODO when using docker-py there is some sort of race/incompatibility here
 		return err
@@ -1554,6 +1562,7 @@ func (c *Container) pause() error {
 	logrus.Debugf("Paused container %s", c.ID())
 
 	c.state.State = define.ContainerStatePaused
+	c.state.HCUnitName = ""
 
 	return c.save()
 }
@@ -1569,6 +1578,28 @@ func (c *Container) unpause() error {
 		return err
 	}
 
+	isStartupHealthCheck := c.config.StartupHealthCheckConfig != nil && !c.state.StartupHCPassed
+	isHealthCheckEnabled := c.config.HealthCheckConfig != nil &&
+		!(len(c.config.HealthCheckConfig.Test) == 1 && c.config.HealthCheckConfig.Test[0] == "NONE")
+	if isHealthCheckEnabled || isStartupHealthCheck {
+		timer := c.config.HealthCheckConfig.Interval.String()
+		if isStartupHealthCheck {
+			timer = c.config.StartupHealthCheckConfig.Interval.String()
+		}
+		if err := c.createTimer(timer, isStartupHealthCheck); err != nil {
+			return err
+		}
+	}
+
+	if isHealthCheckEnabled {
+		if err := c.updateHealthStatus(define.HealthCheckReset); err != nil {
+			return err
+		}
+		if err := c.startTimer(isStartupHealthCheck); err != nil {
+			return err
+		}
+	}
+
 	logrus.Debugf("Unpaused container %s", c.ID())
 
 	c.state.State = define.ContainerStateRunning
diff --git a/test/system/080-pause.bats b/test/system/080-pause.bats
index 8d9b760f74..c818d0849a 100644
--- a/test/system/080-pause.bats
+++ b/test/system/080-pause.bats
@@ -4,6 +4,7 @@
 #
 
 load helpers
+load helpers.systemd
 
 # bats test_tags=distro-integration, ci:parallel
 @test "podman pause/unpause" {
@@ -86,4 +87,52 @@ load helpers
 
     run_podman rm -t 0 -f $cname $cname_notrunning
 }
+
+# bats test_tags=ci:parallel
+@test "podman pause/unpause with HealthCheck interval" {
+    if is_rootless && ! is_cgroupsv2; then
+        skip "'podman pause' (rootless) only works with cgroups v2"
+    fi
+
+    local ctrname="c-$(safename)"
+    local msg="healthmsg-$(random_string)"
+
+    run_podman run -d --name $ctrname     \
+                --health-cmd "echo $msg"  \
+                --health-interval 1s      \
+                $IMAGE /home/podman/pause
+    cid="$output"
+
+    run_podman healthcheck run $ctrname
+    is "$output" "" "output from 'podman healthcheck run'"
+
+    run -0 systemctl status $cid-*.{service,timer}
+    assert "$output" =~ "active" "service should be running"
+
+    run_podman --noout pause $ctrname
+    assert "$output" == "" "output should be empty"
+
+    run -0 systemctl status $cid-*.{service,timer}
+    assert "$output" == "" "service should not be running"
+
+    run_podman --noout unpause $ctrname
+    assert "$output" == "" "output should be empty"
+
+    run_podman healthcheck run $ctrname
+    is "$output" "" "output from 'podman healthcheck run'"
+
+    run -0 systemctl status $cid-*.{service,timer}
+    assert "$output" =~ "active" "service should be running"
+
+    run_podman rm -t 0 -f $ctrname
+
+    # Important check for https://github.com/containers/podman/issues/22884
+    # We never should leak the unit files, healthcheck uses the cid in name so just grep that.
+    # (Ignore .scope units, those are conmon and can linger for 5 minutes)
+    # (Ignore .mount, too. They are created/removed by systemd based on the actual real mounts
+    #  on the host and that is async and might be slow enough in CI to cause failures.)
+    run -0 systemctl list-units --quiet "*$cid*"
+    except_scope_mount=$(grep -vF ".scope " <<<"$output" | { grep -vF ".mount" || true; } )
+    assert "$except_scope_mount" == "" "Healthcheck systemd unit cleanup: no units leaked"
+}
 # vim: filetype=sh