diff --git a/pageserver/src/bin/pageserver.rs b/pageserver/src/bin/pageserver.rs
index 337aa135dc..be7e634d4c 100644
--- a/pageserver/src/bin/pageserver.rs
+++ b/pageserver/src/bin/pageserver.rs
@@ -819,6 +819,7 @@ fn start_pageserver(
             tenant_manager.clone(),
             grpc_auth,
             otel_guard.as_ref().map(|g| g.dispatch.clone()),
+            conf.get_vectored_concurrent_io,
             grpc_listener,
         )?);
     }
diff --git a/pageserver/src/page_service.rs b/pageserver/src/page_service.rs
index 77e5f0a92b..4a1ddf09b5 100644
--- a/pageserver/src/page_service.rs
+++ b/pageserver/src/page_service.rs
@@ -178,6 +178,7 @@ pub fn spawn_grpc(
     tenant_manager: Arc<TenantManager>,
     auth: Option<Arc<SwappableJwtAuth>>,
     perf_trace_dispatch: Option<Dispatch>,
+    get_vectored_concurrent_io: GetVectoredConcurrentIo,
     listener: std::net::TcpListener,
 ) -> anyhow::Result<CancellableTask> {
     let cancel = CancellationToken::new();
@@ -214,6 +215,8 @@ pub fn spawn_grpc(
     let page_service_handler = GrpcPageServiceHandler {
         tenant_manager,
         ctx,
+        gate_guard: gate.enter().expect("gate was just created"),
+        get_vectored_concurrent_io,
     };
 
     let observability_layer = ObservabilityLayer;
@@ -497,10 +500,6 @@ async fn page_service_conn_main(
 }
 
 /// Page service connection handler.
-///
-/// TODO: for gRPC, this will be shared by all requests from all connections.
-/// Decompose it into global state and per-connection/request state, and make
-/// libpq-specific options (e.g. pipelining) separate.
 struct PageServerHandler {
     auth: Option<Arc<SwappableJwtAuth>>,
     claims: Option<Claims>,
@@ -3362,6 +3361,8 @@ where
 pub struct GrpcPageServiceHandler {
     tenant_manager: Arc<TenantManager>,
     ctx: RequestContext,
+    gate_guard: GateGuard,
+    get_vectored_concurrent_io: GetVectoredConcurrentIo,
 }
 
 impl GrpcPageServiceHandler {
@@ -3721,6 +3722,14 @@ impl proto::PageService for GrpcPageServiceHandler {
             .get(ttid.tenant_id, ttid.timeline_id, shard_selector)
             .await?;
 
+        // Spawn an IoConcurrency sidecar, if enabled.
+        let Ok(gate_guard) = self.gate_guard.try_clone() else {
+            return Err(tonic::Status::unavailable("shutting down"));
+        };
+        let io_concurrency =
+            IoConcurrency::spawn_from_conf(self.get_vectored_concurrent_io, gate_guard);
+
+        // Spawn a task to handle the GetPageRequest stream.
         let span = Span::current();
         let ctx = self.ctx.attached_child();
         let mut reqs = req.into_inner();
@@ -3731,8 +3740,7 @@ impl proto::PageService for GrpcPageServiceHandler {
                 .await?
                 .downgrade();
             while let Some(req) = reqs.message().await? {
-                // TODO: implement IoConcurrency sidecar.
-                yield Self::get_page(&ctx, &timeline, req, IoConcurrency::Sequential)
+                yield Self::get_page(&ctx, &timeline, req, io_concurrency.clone())
                     .instrument(span.clone()) // propagate request span
                     .await?
             }