diff --git a/.changeset/wise-garlics-bathe.md b/.changeset/wise-garlics-bathe.md
new file mode 100644
index 000000000000..1f041ca25425
--- /dev/null
+++ b/.changeset/wise-garlics-bathe.md
@@ -0,0 +1,6 @@
+---
+'astro': patch
+'@astrojs/preact': patch
+---
+
+Fix `isSelfAccepting` errors when using the Preact integration with the Astro dev server
diff --git a/packages/astro/src/core/render/dev/index.ts b/packages/astro/src/core/render/dev/index.ts
index 0cf909caf86d..d16cb8923aa2 100644
--- a/packages/astro/src/core/render/dev/index.ts
+++ b/packages/astro/src/core/render/dev/index.ts
@@ -40,21 +40,13 @@ export type ComponentPreload = [SSRLoadedRenderer[], ComponentInstance];
 export type RenderResponse = { type: 'html'; html: string } | { type: 'response'; response: Response };
 
 const svelteStylesRE = /svelte\?svelte&type=style/;
-// Cache renderers to avoid re-resolving the module using Vite's `ssrLoadModule`
-// This prevents an odd exception trying to resolve the same server-side module
-// Multiple times. See `isSelfAccepting` issue: https://github.com/withastro/astro/pull/2852
-const rendererCache = new Map<string, SSRLoadedRenderer['ssr']>();
 
 async function loadRenderer(viteServer: vite.ViteDevServer, renderer: AstroRenderer): Promise<SSRLoadedRenderer> {
-	const { url } = await viteServer.moduleGraph.ensureEntryFromUrl(renderer.serverEntrypoint);
-
-	const cachedRenderer = rendererCache.get(url);
-	if (cachedRenderer) {
-		return { ...renderer, ssr: cachedRenderer };
-	}
-
-	const mod = (await viteServer.ssrLoadModule(url)) as { default: SSRLoadedRenderer['ssr'] };
-	rendererCache.set(url, mod.default);
+	// Vite modules can be out-of-date when using an un-resolved url
+	// We also encountered inconsistencies when using the resolveUrl and resolveId helpers
+	// We've found that pulling the ID directly from the urlToModuleMap is the most stable!
+	const id = viteServer.moduleGraph.urlToModuleMap.get(renderer.serverEntrypoint)?.id ?? renderer.serverEntrypoint;
+	const mod = (await viteServer.ssrLoadModule(id)) as { default: SSRLoadedRenderer['ssr'] };
 	return { ...renderer, ssr: mod.default };
 }
 
diff --git a/packages/integrations/preact/package.json b/packages/integrations/preact/package.json
index c6b705750030..fd8d4b1b71b9 100644
--- a/packages/integrations/preact/package.json
+++ b/packages/integrations/preact/package.json
@@ -20,9 +20,7 @@
   "homepage": "https://astro.build",
   "exports": {
     ".": "./dist/index.js",
-    "./client": "./client",
     "./client.js": "./client.js",
-    "./server": "./server",
     "./server.js": "./server.js",
     "./package.json": "./package.json"
   },
diff --git a/packages/integrations/preact/src/index.ts b/packages/integrations/preact/src/index.ts
index 113284c31372..c96bf1190b48 100644
--- a/packages/integrations/preact/src/index.ts
+++ b/packages/integrations/preact/src/index.ts
@@ -3,8 +3,8 @@ import { AstroIntegration } from 'astro';
 function getRenderer() {
 	return {
 		name: '@astrojs/preact',
-		clientEntrypoint: '@astrojs/preact/client',
-		serverEntrypoint: '@astrojs/preact/server',
+		clientEntrypoint: '@astrojs/preact/client.js',
+		serverEntrypoint: '@astrojs/preact/server.js',
 		jsxImportSource: 'preact',
 		jsxTransformOptions: async () => {
 			const {
@@ -21,8 +21,8 @@ function getRenderer() {
 function getViteConfiguration() {
 	return {
 		optimizeDeps: {
-			include: ['@astrojs/preact/client', 'preact', 'preact/jsx-runtime', 'preact-render-to-string'],
-			exclude: ['@astrojs/preact/server'],
+			include: ['@astrojs/preact/client.js', 'preact', 'preact/jsx-runtime', 'preact-render-to-string'],
+			exclude: ['@astrojs/preact/server.js'],
 		},
 		ssr: {
 			external: ['preact-render-to-string'],