diff --git a/ChangeLog.d/psa-without-genprime-fix.txt b/ChangeLog.d/psa-without-genprime-fix.txt
new file mode 100644
index 000000000..8a7153a9c
--- /dev/null
+++ b/ChangeLog.d/psa-without-genprime-fix.txt
@@ -0,0 +1,5 @@
+Bugfix
+   * Restore the ability to configure PSA via Mbed TLS options to support RSA
+     key pair operations but exclude RSA key generation. When MBEDTLS_GENPRIME
+     is not defined PSA will no longer attempt to use mbedtls_rsa_gen_key().
+     Fixes #4512.
diff --git a/library/psa_crypto.c b/library/psa_crypto.c
index f92b5c472..339370e40 100644
--- a/library/psa_crypto.c
+++ b/library/psa_crypto.c
@@ -4872,7 +4872,8 @@ psa_status_t psa_generate_key_internal(
     }
     else
 
-#if defined(MBEDTLS_PSA_BUILTIN_KEY_TYPE_RSA_KEY_PAIR)
+#if defined(MBEDTLS_PSA_BUILTIN_KEY_TYPE_RSA_KEY_PAIR) && \
+    defined(MBEDTLS_GENPRIME)
     if ( type == PSA_KEY_TYPE_RSA_KEY_PAIR )
     {
         return( mbedtls_psa_rsa_generate_key( attributes,
@@ -4881,7 +4882,8 @@ psa_status_t psa_generate_key_internal(
                                               key_buffer_length ) );
     }
     else
-#endif /* defined(MBEDTLS_PSA_BUILTIN_KEY_TYPE_RSA_KEY_PAIR) */
+#endif /* defined(MBEDTLS_PSA_BUILTIN_KEY_TYPE_RSA_KEY_PAIR)
+        * defined(MBEDTLS_GENPRIME) */
 
 #if defined(MBEDTLS_PSA_BUILTIN_KEY_TYPE_ECC_KEY_PAIR)
     if ( PSA_KEY_TYPE_IS_ECC( type ) && PSA_KEY_TYPE_IS_KEY_PAIR( type ) )
diff --git a/library/psa_crypto_rsa.c b/library/psa_crypto_rsa.c
index 1ab1e9491..08db7a428 100644
--- a/library/psa_crypto_rsa.c
+++ b/library/psa_crypto_rsa.c
@@ -274,7 +274,8 @@ static psa_status_t rsa_export_public_key(
 #endif /* defined(BUILTIN_KEY_TYPE_RSA_KEY_PAIR) ||
         * defined(BUILTIN_KEY_TYPE_RSA_PUBLIC_KEY) */
 
-#if defined(BUILTIN_KEY_TYPE_RSA_KEY_PAIR)
+#if defined(BUILTIN_KEY_TYPE_RSA_KEY_PAIR) && \
+    defined(MBEDTLS_GENPRIME)
 static psa_status_t psa_rsa_read_exponent( const uint8_t *domain_parameters,
                                            size_t domain_parameters_size,
                                            int *exponent )
@@ -332,7 +333,8 @@ static psa_status_t rsa_generate_key(
 
     return( status );
 }
-#endif /* defined(BUILTIN_KEY_TYPE_RSA_KEY_PAIR) */
+#endif /* defined(BUILTIN_KEY_TYPE_RSA_KEY_PAIR)
+        * defined(MBEDTLS_GENPRIME) */
 
 /****************************************************************/
 /* Sign/verify hashes */
@@ -565,7 +567,8 @@ psa_status_t mbedtls_psa_rsa_export_public_key(
 #endif /* defined(MBEDTLS_PSA_BUILTIN_KEY_TYPE_RSA_KEY_PAIR) ||
         * defined(MBEDTLS_PSA_BUILTIN_KEY_TYPE_RSA_PUBLIC_KEY) */
 
-#if defined(MBEDTLS_PSA_BUILTIN_KEY_TYPE_RSA_KEY_PAIR)
+#if defined(MBEDTLS_PSA_BUILTIN_KEY_TYPE_RSA_KEY_PAIR) && \
+    defined(MBEDTLS_GENPRIME)
 psa_status_t mbedtls_psa_rsa_generate_key(
     const psa_key_attributes_t *attributes,
     uint8_t *key_buffer, size_t key_buffer_size, size_t *key_buffer_length )
@@ -573,7 +576,8 @@ psa_status_t mbedtls_psa_rsa_generate_key(
     return( rsa_generate_key( attributes, key_buffer, key_buffer_size,
                               key_buffer_length ) );
 }
-#endif /* defined(MBEDTLS_PSA_BUILTIN_KEY_TYPE_RSA_KEY_PAIR) */
+#endif /* defined(MBEDTLS_PSA_BUILTIN_KEY_TYPE_RSA_KEY_PAIR)
+        * defined(MBEDTLS_GENPRIME) */
 
 #if defined(MBEDTLS_PSA_BUILTIN_ALG_RSA_PKCS1V15_SIGN) || \
     defined(MBEDTLS_PSA_BUILTIN_ALG_RSA_PSS)
diff --git a/tests/scripts/all.sh b/tests/scripts/all.sh
index 0713ed40f..dd3dbb739 100755
--- a/tests/scripts/all.sh
+++ b/tests/scripts/all.sh
@@ -848,6 +848,15 @@ support_test_zlib_cmake () {
     support_test_zlib_make "$@"
 }
 
+component_test_psa_crypto_rsa_no_genprime() {
+    msg "build: default config minus MBEDTLS_GENPRIME"
+    scripts/config.py unset MBEDTLS_GENPRIME
+    make
+
+    msg "test: default config minus MBEDTLS_GENPRIME"
+    make test
+}
+
 component_test_ref_configs () {
     msg "test/build: ref-configs (ASan build)" # ~ 6 min 20s
     CC=gcc cmake -D CMAKE_BUILD_TYPE:String=Asan .
diff --git a/tests/suites/test_suite_psa_crypto.data b/tests/suites/test_suite_psa_crypto.data
index cb0cb9cd4..4d9c7b69b 100644
--- a/tests/suites/test_suite_psa_crypto.data
+++ b/tests/suites/test_suite_psa_crypto.data
@@ -3369,7 +3369,7 @@ depends_on:PSA_WANT_ALG_RSA_PKCS1V15_CRYPT:PSA_WANT_KEY_TYPE_RSA_KEY_PAIR:MBEDTL
 generate_key:PSA_KEY_TYPE_RSA_KEY_PAIR:512:PSA_KEY_USAGE_EXPORT | PSA_KEY_USAGE_ENCRYPT | PSA_KEY_USAGE_DECRYPT:PSA_ALG_RSA_PKCS1V15_CRYPT:PSA_SUCCESS:0
 
 PSA generate key: RSA, 1024 bits, good, encrypt (OAEP SHA-256)
-depends_on:PSA_WANT_ALG_RSA_OAEP:PSA_WANT_ALG_SHA_256:PSA_WANT_KEY_TYPE_RSA_KEY_PAIR:MBEDTLS_MD_C
+depends_on:PSA_WANT_ALG_RSA_OAEP:PSA_WANT_ALG_SHA_256:PSA_WANT_KEY_TYPE_RSA_KEY_PAIR:MBEDTLS_GENPRIME:MBEDTLS_MD_C
 generate_key:PSA_KEY_TYPE_RSA_KEY_PAIR:1024:PSA_KEY_USAGE_EXPORT | PSA_KEY_USAGE_ENCRYPT | PSA_KEY_USAGE_DECRYPT:PSA_ALG_RSA_OAEP(PSA_ALG_SHA_256):PSA_SUCCESS:0
 
 PSA generate key: RSA, 0 bits: invalid