diff --git a/synapse/storage/databases/main/sticky_events.py b/synapse/storage/databases/main/sticky_events.py
index 925a640f56..f8ca147431 100644
--- a/synapse/storage/databases/main/sticky_events.py
+++ b/synapse/storage/databases/main/sticky_events.py
@@ -25,9 +25,12 @@ from typing import (
     cast,
 )
 
+from twisted.internet.defer import Deferred
+
 from synapse.api.constants import EventTypes, StickyEvent
 from synapse.events import EventBase
 from synapse.events.snapshot import EventPersistencePair
+from synapse.metrics.background_process_metrics import run_as_background_process
 from synapse.replication.tcp.streams._base import StickyEventsStream
 from synapse.storage.database import (
     DatabasePool,
@@ -44,6 +47,12 @@ if TYPE_CHECKING:
 
 logger = logging.getLogger(__name__)
 
+# Remove entries from the sticky_events table at this frequency.
+# Note: this does NOT mean we don't honour shorter expiration timeouts.
+# Consumers call 'get_sticky_events_in_rooms' which has `WHERE expires_at > ?`
+# to filter out expired sticky events that have yet to be deleted.
+DELETE_EXPIRED_STICKY_EVENTS_MS = 60 * 1000 * 60  # 1 hour
+
 
 class StickyEventsWorkerStore(CacheInvalidationWorkerStore):
     def __init__(
@@ -58,6 +67,12 @@ class StickyEventsWorkerStore(CacheInvalidationWorkerStore):
             self._instance_name in hs.config.worker.writers.events
         )
 
+        # Technically this means we will cleanup N times, once per event persister, maybe put on master?
+        if self._can_write_to_sticky_events:
+            self._clock.looping_call(
+                self._run_background_cleanup, DELETE_EXPIRED_STICKY_EVENTS_MS
+            )
+
         self._sticky_events_id_gen: MultiWriterIdGenerator = MultiWriterIdGenerator(
             db_conn=db_conn,
             db=database,
@@ -426,5 +441,30 @@ class StickyEventsWorkerStore(CacheInvalidationWorkerStore):
         # We know the events are otherwise authorised, so we only need to load the current state
         # and check if the events pass auth at the current state.
 
+    async def _delete_expired_sticky_events(self) -> None:
+        logger.info("delete_expired_sticky_events")
+        await self.db_pool.runInteraction(
+            "_delete_expired_sticky_events",
+            self._delete_expired_sticky_events_txn,
+            self._now(),
+        )
+
+    def _delete_expired_sticky_events_txn(
+        self, txn: LoggingTransaction, now: int
+    ) -> None:
+        txn.execute(
+            """
+            DELETE FROM sticky_events WHERE expires_at < ?
+            """,
+            (now,),
+        )
+
     def _now(self) -> int:
         return round(time.time() * 1000)
+
+    def _run_background_cleanup(self) -> Deferred:
+        return run_as_background_process(
+            "delete_expired_sticky_events",
+            self.server_name,
+            self._delete_expired_sticky_events,
+        )