diff --git a/src/Analyzers/CSharp/Analyzers/UsePatternCombinators/AnalyzedPattern.cs b/src/Analyzers/CSharp/Analyzers/UsePatternCombinators/AnalyzedPattern.cs
index 3fec548f72e15..c10784732b8c2 100644
--- a/src/Analyzers/CSharp/Analyzers/UsePatternCombinators/AnalyzedPattern.cs
+++ b/src/Analyzers/CSharp/Analyzers/UsePatternCombinators/AnalyzedPattern.cs
@@ -154,6 +154,19 @@ private Binary(AnalyzedPattern leftPattern, AnalyzedPattern rightPattern, bool i
             if (!AreEquivalent(target.Syntax, compareTarget.Syntax))
                 return null;
 
+            // An &&/|| expression that looks the same on both sides.  This looks like something we could merge into an
+            // 'and/or' pattern that only executes the target once, and compares the result to multiple constants.
+            // However, we disqualify certain forms as they strongly imply that executing the target multiple times
+            // is necessary.  For example:
+            //
+            //  `if (ReadValue(x, ref index) == A && ReadValue(x, ref index) == B)`
+            //
+            // This should not get converted to `if (ReadValue(x, ref index) == A and B)`.
+            //
+            // This list is not exhaustive and can be expanded as needed.
+            if (target.Syntax.DescendantNodesAndSelf().OfType<ArgumentSyntax>().Any(a => a.RefKindKeyword.Kind() is SyntaxKind.RefKeyword))
+                return null;
+
             return new Binary(leftPattern, rightPattern, isDisjunctive, token, target);
         }
     }
diff --git a/src/Analyzers/CSharp/Analyzers/UsePatternCombinators/CSharpUsePatternCombinatorsDiagnosticAnalyzer.cs b/src/Analyzers/CSharp/Analyzers/UsePatternCombinators/CSharpUsePatternCombinatorsDiagnosticAnalyzer.cs
index 8bc17b8207a5b..0f71c68e633be 100644
--- a/src/Analyzers/CSharp/Analyzers/UsePatternCombinators/CSharpUsePatternCombinatorsDiagnosticAnalyzer.cs
+++ b/src/Analyzers/CSharp/Analyzers/UsePatternCombinators/CSharpUsePatternCombinatorsDiagnosticAnalyzer.cs
@@ -9,7 +9,6 @@
 using Microsoft.CodeAnalysis.CSharp.Extensions;
 using Microsoft.CodeAnalysis.CSharp.Syntax;
 using Microsoft.CodeAnalysis.Diagnostics;
-using Microsoft.CodeAnalysis.Operations;
 using Microsoft.CodeAnalysis.Shared.Extensions;
 
 namespace Microsoft.CodeAnalysis.CSharp.UsePatternCombinators;
@@ -17,8 +16,13 @@ namespace Microsoft.CodeAnalysis.CSharp.UsePatternCombinators;
 using static AnalyzedPattern;
 
 [DiagnosticAnalyzer(LanguageNames.CSharp)]
-internal sealed class CSharpUsePatternCombinatorsDiagnosticAnalyzer :
-    AbstractBuiltInCodeStyleDiagnosticAnalyzer
+internal sealed class CSharpUsePatternCombinatorsDiagnosticAnalyzer() :
+    AbstractBuiltInCodeStyleDiagnosticAnalyzer(
+        IDEDiagnosticIds.UsePatternCombinatorsDiagnosticId,
+        EnforceOnBuildValues.UsePatternCombinators,
+        CSharpCodeStyleOptions.PreferPatternMatching,
+        s_safePatternTitle,
+        s_safePatternTitle)
 {
     private const string SafeKey = "safe";
 
@@ -32,15 +36,6 @@ internal sealed class CSharpUsePatternCombinatorsDiagnosticAnalyzer :
         hasAnyCodeStyleOption: true,
         s_unsafePatternTitle);
 
-    public CSharpUsePatternCombinatorsDiagnosticAnalyzer()
-        : base(IDEDiagnosticIds.UsePatternCombinatorsDiagnosticId,
-            EnforceOnBuildValues.UsePatternCombinators,
-            CSharpCodeStyleOptions.PreferPatternMatching,
-            s_safePatternTitle,
-            s_safePatternTitle)
-    {
-    }
-
     public static bool IsSafe(Diagnostic diagnostic)
         => diagnostic.Properties.ContainsKey(SafeKey);
 
diff --git a/src/Features/CSharpTest/UsePatternCombinators/CSharpUsePatternCombinatorsDiagnosticAnalyzerTests.cs b/src/Features/CSharpTest/UsePatternCombinators/CSharpUsePatternCombinatorsDiagnosticAnalyzerTests.cs
index a41fc3a0568ff..ef0c58068ab99 100644
--- a/src/Features/CSharpTest/UsePatternCombinators/CSharpUsePatternCombinatorsDiagnosticAnalyzerTests.cs
+++ b/src/Features/CSharpTest/UsePatternCombinators/CSharpUsePatternCombinatorsDiagnosticAnalyzerTests.cs
@@ -20,20 +20,16 @@
 namespace Microsoft.CodeAnalysis.Editor.CSharp.UnitTests.UsePatternCombinators;
 
 [Trait(Traits.Feature, Traits.Features.CodeActionsUsePatternCombinators)]
-public class CSharpUsePatternCombinatorsDiagnosticAnalyzerTests : AbstractCSharpDiagnosticProviderBasedUserDiagnosticTest_NoEditor
+public sealed class CSharpUsePatternCombinatorsDiagnosticAnalyzerTests(ITestOutputHelper logger)
+    : AbstractCSharpDiagnosticProviderBasedUserDiagnosticTest_NoEditor(logger)
 {
     private static readonly ParseOptions CSharp9 = TestOptions.RegularPreview.WithLanguageVersion(LanguageVersion.CSharp9);
 
-    private static readonly OptionsCollection s_disabled = new OptionsCollection(LanguageNames.CSharp)
+    private static readonly OptionsCollection s_disabled = new(LanguageNames.CSharp)
     {
         { CSharpCodeStyleOptions.PreferPatternMatching, new CodeStyleOption2<bool>(false, NotificationOption2.None) }
     };
 
-    public CSharpUsePatternCombinatorsDiagnosticAnalyzerTests(ITestOutputHelper logger)
-         : base(logger)
-    {
-    }
-
     internal override (DiagnosticAnalyzer, CodeFixProvider) CreateDiagnosticProviderAndFixer(Workspace workspace)
         => (new CSharpUsePatternCombinatorsDiagnosticAnalyzer(), new CSharpUsePatternCombinatorsCodeFixProvider());
 
@@ -694,4 +690,34 @@ private void M(object o)
             }
             """);
     }
+
+    [Fact, WorkItem("https://github.com/dotnet/roslyn/issues/75122")]
+    public async Task TestNotWithMultipleCallsToInvocationWithRefArgument()
+    {
+        await TestMissingAsync(
+            """
+            using System;
+
+            static class DataUtils
+            {
+                internal static string ReadLine(byte[] bytes, ref int index)
+                {
+                    throw new NotImplementedException();
+                }
+            }
+
+            class C
+            {
+                public void Main(byte[] bytes)
+                {
+                    int index = 0;
+
+                    if ([|DataUtils.ReadLine(bytes, ref index) != "YAFC" || DataUtils.ReadLine(bytes, ref index) != "ProjectPage"|])
+                    {
+                        throw new InvalidDataException();
+                    }
+                }
+            }
+            """);
+    }
 }