diff --git a/demo/markdownlint-browser.js b/demo/markdownlint-browser.js
index f8448a4e..941c17cf 100644
--- a/demo/markdownlint-browser.js
+++ b/demo/markdownlint-browser.js
@@ -6050,9 +6050,12 @@ var _require = __webpack_require__(/*! ../helpers */ "../helpers/helpers.js"),
 var _require2 = __webpack_require__(/*! ../helpers/micromark.cjs */ "../helpers/micromark.cjs"),
   filterByTypes = _require2.filterByTypes,
   tokenIfType = _require2.tokenIfType;
+var intrawordRe = /\w/;
 var impl = function impl(params, onError, type, asterisk, underline) {
   var style = arguments.length > 5 && arguments[5] !== undefined ? arguments[5] : "consistent";
-  var emphasisTokens = filterByTypes(params.parsers.micromark.tokens, [type]);
+  var lines = params.lines,
+    parsers = params.parsers;
+  var emphasisTokens = filterByTypes(parsers.micromark.tokens, [type]);
   var _iterator = _createForOfIteratorHelper(emphasisTokens),
     _step;
   try {
@@ -6068,13 +6071,16 @@ var impl = function impl(params, onError, type, asterisk, underline) {
           style = markupStyle;
         }
         if (style !== markupStyle) {
-          for (var _i = 0, _arr = [startSequence, endSequence]; _i < _arr.length; _i++) {
-            var sequence = _arr[_i];
-            addError(onError, sequence.startLine, "Expected: ".concat(style, "; Actual: ").concat(markupStyle), undefined, [sequence.startColumn, sequence.text.length], {
-              "editColumn": sequence.startColumn,
-              "deleteCount": sequence.text.length,
-              "insertText": style === "asterisk" ? asterisk : underline
-            });
+          var underscoreIntraword = style === "underscore" && (intrawordRe.test(lines[startSequence.startLine - 1][startSequence.startColumn - 2]) || intrawordRe.test(lines[endSequence.endLine - 1][endSequence.endColumn - 1]));
+          if (!underscoreIntraword) {
+            for (var _i = 0, _arr = [startSequence, endSequence]; _i < _arr.length; _i++) {
+              var sequence = _arr[_i];
+              addError(onError, sequence.startLine, "Expected: ".concat(style, "; Actual: ").concat(markupStyle), undefined, [sequence.startColumn, sequence.text.length], {
+                "editColumn": sequence.startColumn,
+                "deleteCount": sequence.text.length,
+                "insertText": style === "asterisk" ? asterisk : underline
+              });
+            }
           }
         }
       }
diff --git a/lib/md049-md050.js b/lib/md049-md050.js
index 270836b4..91556188 100644
--- a/lib/md049-md050.js
+++ b/lib/md049-md050.js
@@ -5,10 +5,13 @@
 const { addError, emphasisOrStrongStyleFor } = require("../helpers");
 const { filterByTypes, tokenIfType } = require("../helpers/micromark.cjs");
 
+const intrawordRe = /\w/;
+
 const impl =
   (params, onError, type, asterisk, underline, style = "consistent") => {
+    const { lines, parsers } = params;
     const emphasisTokens =
-      filterByTypes(params.parsers.micromark.tokens, [ type ]);
+      filterByTypes(parsers.micromark.tokens, [ type ]);
     for (const token of emphasisTokens) {
       const { children } = token;
       const childType = `${type}Sequence`;
@@ -20,19 +23,29 @@ const impl =
           style = markupStyle;
         }
         if (style !== markupStyle) {
-          for (const sequence of [ startSequence, endSequence ]) {
-            addError(
-              onError,
-              sequence.startLine,
-              `Expected: ${style}; Actual: ${markupStyle}`,
-              undefined,
-              [ sequence.startColumn, sequence.text.length ],
-              {
-                "editColumn": sequence.startColumn,
-                "deleteCount": sequence.text.length,
-                "insertText": (style === "asterisk") ? asterisk : underline
-              }
-            );
+          const underscoreIntraword = (style === "underscore") && (
+            intrawordRe.test(
+              lines[startSequence.startLine - 1][startSequence.startColumn - 2]
+            ) ||
+            intrawordRe.test(
+              lines[endSequence.endLine - 1][endSequence.endColumn - 1]
+            )
+          );
+          if (!underscoreIntraword) {
+            for (const sequence of [ startSequence, endSequence ]) {
+              addError(
+                onError,
+                sequence.startLine,
+                `Expected: ${style}; Actual: ${markupStyle}`,
+                undefined,
+                [ sequence.startColumn, sequence.text.length ],
+                {
+                  "editColumn": sequence.startColumn,
+                  "deleteCount": sequence.text.length,
+                  "insertText": (style === "asterisk") ? asterisk : underline
+                }
+              );
+            }
           }
         }
       }
diff --git a/test/emphasis_style_asterisk.md b/test/emphasis_style_asterisk.md
index 61ce4fbc..9afcf052 100644
--- a/test/emphasis_style_asterisk.md
+++ b/test/emphasis_style_asterisk.md
@@ -4,7 +4,12 @@ This is *fine*
 
 This is _not_ {MD049}
 
+Internal emphasis is preserved:
+apple*banana*cherry, apple*banana*, *banana*cherry
+apple_banana_cherry, apple_banana_, _banana_cherry
+
 <!-- markdownlint-configure-file {
+  "MD037": false,
   "MD049": {
     "style": "asterisk"
   }
diff --git a/test/emphasis_style_underscore.md b/test/emphasis_style_underscore.md
index e6e8bd3d..8e781874 100644
--- a/test/emphasis_style_underscore.md
+++ b/test/emphasis_style_underscore.md
@@ -4,7 +4,12 @@ This is _fine_
 
 This is *not* {MD049}
 
+Internal emphasis is preserved:
+apple*banana*cherry, apple*banana*, *banana*cherry
+apple_banana_cherry, apple_banana_, _banana_cherry
+
 <!-- markdownlint-configure-file {
+  "MD037": false,
   "MD049": {
     "style": "underscore"
   }
diff --git a/test/snapshots/markdownlint-test-scenarios.js.md b/test/snapshots/markdownlint-test-scenarios.js.md
index 17e0efff..a0be6b5f 100644
--- a/test/snapshots/markdownlint-test-scenarios.js.md
+++ b/test/snapshots/markdownlint-test-scenarios.js.md
@@ -10754,7 +10754,12 @@ Generated by [AVA](https://avajs.dev).
       ␊
       This is *not* {MD049}␊
       ␊
+      Internal emphasis is preserved:␊
+      apple*banana*cherry, apple*banana*, *banana*cherry␊
+      apple_banana_cherry, apple_banana_, _banana_cherry␊
+      ␊
       <!-- markdownlint-configure-file {␊
+        "MD037": false,␊
         "MD049": {␊
           "style": "asterisk"␊
         }␊
@@ -10815,7 +10820,12 @@ Generated by [AVA](https://avajs.dev).
       ␊
       This is _not_ {MD049}␊
       ␊
+      Internal emphasis is preserved:␊
+      apple*banana*cherry, apple*banana*, *banana*cherry␊
+      apple_banana_cherry, apple_banana_, _banana_cherry␊
+      ␊
       <!-- markdownlint-configure-file {␊
+        "MD037": false,␊
         "MD049": {␊
           "style": "underscore"␊
         }␊
@@ -44028,6 +44038,10 @@ Generated by [AVA](https://avajs.dev).
       ␊
       This is **not** {MD050}␊
       ␊
+      Internal emphasis is preserved:␊
+      apple**banana**cherry, apple**banana**, **banana**cherry␊
+      apple__banana__cherry, apple__banana__, __banana__cherry␊
+      ␊
       <!-- markdownlint-configure-file {␊
         "MD050": {␊
           "style": "asterisk"␊
@@ -44089,6 +44103,10 @@ Generated by [AVA](https://avajs.dev).
       ␊
       This is __not__ {MD050}␊
       ␊
+      Internal emphasis is preserved:␊
+      apple**banana**cherry, apple**banana**, **banana**cherry␊
+      apple__banana__cherry, apple__banana__, __banana__cherry␊
+      ␊
       <!-- markdownlint-configure-file {␊
         "MD050": {␊
           "style": "underscore"␊
diff --git a/test/snapshots/markdownlint-test-scenarios.js.snap b/test/snapshots/markdownlint-test-scenarios.js.snap
index d9fbc557..d5a9d1ec 100644
Binary files a/test/snapshots/markdownlint-test-scenarios.js.snap and b/test/snapshots/markdownlint-test-scenarios.js.snap differ
diff --git a/test/strong_style_asterisk.md b/test/strong_style_asterisk.md
index b5d75983..3151cd07 100644
--- a/test/strong_style_asterisk.md
+++ b/test/strong_style_asterisk.md
@@ -4,6 +4,10 @@ This is **fine**
 
 This is __not__ {MD050}
 
+Internal emphasis is preserved:
+apple**banana**cherry, apple**banana**, **banana**cherry
+apple__banana__cherry, apple__banana__, __banana__cherry
+
 <!-- markdownlint-configure-file {
   "MD050": {
     "style": "asterisk"
diff --git a/test/strong_style_underscore.md b/test/strong_style_underscore.md
index f8437492..92a270c5 100644
--- a/test/strong_style_underscore.md
+++ b/test/strong_style_underscore.md
@@ -4,6 +4,10 @@ This is __fine__
 
 This is **not** {MD050}
 
+Internal emphasis is preserved:
+apple**banana**cherry, apple**banana**, **banana**cherry
+apple__banana__cherry, apple__banana__, __banana__cherry
+
 <!-- markdownlint-configure-file {
   "MD050": {
     "style": "underscore"