diff --git a/google/cloud/pubsub_v1/open_telemetry/subscribe_opentelemetry.py b/google/cloud/pubsub_v1/open_telemetry/subscribe_opentelemetry.py
index 1ec142077..96f2c53e5 100644
--- a/google/cloud/pubsub_v1/open_telemetry/subscribe_opentelemetry.py
+++ b/google/cloud/pubsub_v1/open_telemetry/subscribe_opentelemetry.py
@@ -45,9 +45,12 @@ def __init__(self, message: PubsubMessage):
         self._scheduler_span: Optional[trace.Span] = None
 
         # This will be set by `start_subscribe_span` method and will be used
-        # for other spans, such as
+        # for other spans, such as process span.
         self._subscription_id: Optional[str] = None
 
+        # This will be set by `start_process_span` method.
+        self._process_span: Optional[trace.Span] = None
+
     @property
     def subscription_id(self):
         return self._subscription_id
@@ -136,3 +139,23 @@ def start_subscribe_scheduler_span(self) -> None:
     def end_subscribe_scheduler_span(self) -> None:
         assert self._scheduler_span is not None
         self._scheduler_span.end()
+
+    def start_process_span(self) -> None:
+        assert self._subscribe_span is not None
+        tracer = trace.get_tracer(self._OPEN_TELEMETRY_TRACER_NAME)
+        publish_create_span_link: Optional[trace.Link] = (
+            trace.Link(self._subscribe_span.parent)
+            if self._subscribe_span.parent
+            else None
+        )
+        with tracer.start_as_current_span(
+            name=f"{self._subscription_id} process",
+            attributes={
+                "messaging.system": self._OPEN_TELEMETRY_MESSAGING_SYSTEM,
+            },
+            kind=trace.SpanKind.INTERNAL,
+            context=set_span_in_context(self._subscribe_span),
+            links=[publish_create_span_link] if publish_create_span_link else None,
+            end_on_exit=False,
+        ) as process_span:
+            self._process_span = process_span
diff --git a/google/cloud/pubsub_v1/subscriber/_protocol/streaming_pull_manager.py b/google/cloud/pubsub_v1/subscriber/_protocol/streaming_pull_manager.py
index 4b3df6df0..cc815f114 100644
--- a/google/cloud/pubsub_v1/subscriber/_protocol/streaming_pull_manager.py
+++ b/google/cloud/pubsub_v1/subscriber/_protocol/streaming_pull_manager.py
@@ -128,6 +128,7 @@ def _wrap_callback_errors(
     try:
         if message.opentelemetry_data:
             message.opentelemetry_data.end_subscribe_concurrency_control_span()
+            message.opentelemetry_data.start_process_span()
         callback(message)
     except BaseException as exc:
         # Note: the likelihood of this failing is extremely low. This just adds
diff --git a/tests/unit/pubsub_v1/subscriber/test_subscribe_opentelemetry.py b/tests/unit/pubsub_v1/subscriber/test_subscribe_opentelemetry.py
index aad87ebdf..8a5542493 100644
--- a/tests/unit/pubsub_v1/subscriber/test_subscribe_opentelemetry.py
+++ b/tests/unit/pubsub_v1/subscriber/test_subscribe_opentelemetry.py
@@ -124,3 +124,10 @@ def test_opentelemetry_end_subscribe_scheduler_span_assertion_error():
     opentelemetry_data = SubscribeOpenTelemetry(msg)
     with pytest.raises(AssertionError):
         opentelemetry_data.end_subscribe_scheduler_span()
+
+
+def test_opentelemetry_start_process_span_assertion_error():
+    msg = create_message(b"foo")
+    opentelemetry_data = SubscribeOpenTelemetry(msg)
+    with pytest.raises(AssertionError):
+        opentelemetry_data.start_process_span()