diff --git a/ibis/backends/mssql/__init__.py b/ibis/backends/mssql/__init__.py
index 32ab15166a56..2582476b18b7 100644
--- a/ibis/backends/mssql/__init__.py
+++ b/ibis/backends/mssql/__init__.py
@@ -602,7 +602,7 @@ def create_table(
         *,
         schema: sch.SchemaLike | None = None,
         database: str | None = None,
-        temp: bool = False,
+        temp: bool | None = None,
         overwrite: bool = False,
     ) -> ir.Table:
         """Create a new table.
@@ -682,7 +682,7 @@ def create_table(
         raw_table = sg.table(temp_name, catalog=catalog, db=db, quoted=False)
         target = sge.Schema(
             this=sg.table(
-                "#" * temp + temp_name, catalog=catalog, db=db, quoted=quoted
+                "#" * bool(temp) + temp_name, catalog=catalog, db=db, quoted=quoted
             ),
             expressions=schema.to_sqlglot(self.dialect),
         )
@@ -701,7 +701,7 @@ def create_table(
                 # for the subsequent `Insert`, so we need to shove a `#` in
                 # front of the table identifier.
                 _table = sg.table(
-                    "##" * temp + temp_name,
+                    "##" * bool(temp) + temp_name,
                     catalog=catalog,
                     db=db,
                     quoted=self.compiler.quoted,
diff --git a/ibis/backends/mssql/tests/test_client.py b/ibis/backends/mssql/tests/test_client.py
index 3a72a75746c1..6850f489852c 100644
--- a/ibis/backends/mssql/tests/test_client.py
+++ b/ibis/backends/mssql/tests/test_client.py
@@ -18,6 +18,8 @@
     MSSQL_PYODBC_DRIVER,
     MSSQL_USER,
 )
+from ibis.backends.tests.errors import PyODBCProgrammingError
+from ibis.util import gen_name
 
 RAW_DB_TYPES = [
     # Exact numbers
@@ -259,3 +261,36 @@ def test_dot_sql_with_unnamed_columns(con):
 
     df = expr.execute()
     assert len(df) == 1
+
+
+@pytest.mark.parametrize(
+    "temp",
+    [
+        param(
+            True,
+            marks=pytest.mark.xfail(
+                raises=PyODBCProgrammingError,
+                reason="dropping temp tables isn't implemented",
+            ),
+        ),
+        False,
+        None,
+    ],
+    ids=[
+        "temp",
+        "no-temp",
+        "no-temp-none",
+    ],
+)
+def test_create_temp_table(con, temp):
+    t = con.create_table(
+        name := gen_name("mssql_delete_me"),
+        schema={"a": "int"},
+        temp=temp,
+    )
+    try:
+        assert int(t.count().execute()) == 0
+        assert t.schema() == ibis.schema({"a": "int"})
+        assert t.columns == ("a",)
+    finally:
+        con.drop_table(name)