diff --git a/sdk/monitor/azure-monitor-opentelemetry/CHANGELOG.md b/sdk/monitor/azure-monitor-opentelemetry/CHANGELOG.md
index 940554b92da4..4c9204813b00 100644
--- a/sdk/monitor/azure-monitor-opentelemetry/CHANGELOG.md
+++ b/sdk/monitor/azure-monitor-opentelemetry/CHANGELOG.md
@@ -3,6 +3,9 @@
 ## 1.8.8 (Unreleased)
 
 ### Features Added
+- Register GenAI main-agent attribution processors to automatically propagate
+  `microsoft.gen_ai.main_agent.*` attributes in multi-agent GenAI systems per [spec](https://github.com/aep-health-and-standards/Telemetry-Collection-Spec/blob/main/ApplicationInsights/genai_main_agent_attribution.md)
+  ([#46703](https://github.com/Azure/azure-sdk-for-python/pull/46703))
 
 ### Breaking Changes
 
diff --git a/sdk/monitor/azure-monitor-opentelemetry/azure/monitor/opentelemetry/_configure.py b/sdk/monitor/azure-monitor-opentelemetry/azure/monitor/opentelemetry/_configure.py
index 415b522509b5..1f98f2eabde8 100644
--- a/sdk/monitor/azure-monitor-opentelemetry/azure/monitor/opentelemetry/_configure.py
+++ b/sdk/monitor/azure-monitor-opentelemetry/azure/monitor/opentelemetry/_configure.py
@@ -59,6 +59,10 @@
     _QuickpulseLogRecordProcessor,
     _QuickpulseSpanProcessor,
 )
+from azure.monitor.opentelemetry.exporter._gen_ai._processor import (  # pylint: disable=import-error,no-name-in-module
+    _GenAIMainAgentLogRecordProcessor,
+    _GenAIMainAgentSpanProcessor,
+)
 from azure.monitor.opentelemetry.exporter import (  # pylint: disable=import-error,no-name-in-module
     ApplicationInsightsSampler,
     AzureMonitorMetricExporter,
@@ -182,6 +186,8 @@ def _setup_tracing(configurations: Dict[str, ConfigurationValue]):
             sampler=RateLimitedSampler(target_spans_per_second_limit=cast(float, traces_per_second)), resource=resource
         )
 
+    # GenAI main-agent attribution processor must be registered first
+    tracer_provider.add_span_processor(_GenAIMainAgentSpanProcessor())
     for span_processor in configurations[SPAN_PROCESSORS_ARG]:  # type: ignore
         tracer_provider.add_span_processor(span_processor)  # type: ignore
     if configurations.get(ENABLE_LIVE_METRICS_ARG):
@@ -235,6 +241,8 @@ def _setup_logging(configurations: Dict[str, ConfigurationValue]):
         enable_performance_counters_config = configurations[ENABLE_PERFORMANCE_COUNTERS_ARG]
         logger_provider = LoggerProvider(resource=resource)
         enable_trace_based_sampling_for_logs = configurations[ENABLE_TRACE_BASED_SAMPLING_ARG]
+        # GenAI main-agent attribution processor must be registered first
+        logger_provider.add_log_record_processor(_GenAIMainAgentLogRecordProcessor())
         for custom_log_record_processor in configurations[LOG_RECORD_PROCESSORS_ARG]:  # type: ignore
             logger_provider.add_log_record_processor(custom_log_record_processor)  # type: ignore
         if configurations.get(ENABLE_LIVE_METRICS_ARG):