diff --git a/features/uninstall-extensions.feature b/features/uninstall-extensions.feature
index 154c10cf..1167897e 100644
--- a/features/uninstall-extensions.feature
+++ b/features/uninstall-extensions.feature
@@ -1,7 +1,5 @@
 Feature: Extensions can be uninstalled with PIE
 
-  # See https://github.com/php/pie/issues/190 for why this is non-Windows
-  @non-windows
   Example: An extension can be uninstalled
     Given an extension was previously installed
     When I run a command to uninstall an extension
diff --git a/src/Command/UninstallCommand.php b/src/Command/UninstallCommand.php
index 0e6997bf..0cd46dc9 100644
--- a/src/Command/UninstallCommand.php
+++ b/src/Command/UninstallCommand.php
@@ -5,7 +5,6 @@
 namespace Php\Pie\Command;
 
 use Composer\Composer;
-use Composer\Util\Platform;
 use Php\Pie\ComposerIntegration\ComposerIntegrationHandler;
 use Php\Pie\ComposerIntegration\PieComposerFactory;
 use Php\Pie\ComposerIntegration\PieComposerRequest;
@@ -54,16 +53,6 @@ public function configure(): void
 
     public function execute(InputInterface $input, OutputInterface $output): int
     {
-        if (Platform::isWindows()) {
-            /**
-             * @todo add support for uninstalling in Windows - see
-             *       {@link https://github.com/php/pie/issues/190} for details
-             */
-            $output->writeln('<comment>Uninstalling extensions on Windows is not currently supported.</comment>');
-
-            return 1;
-        }
-
         if (! TargetPlatform::isRunningAsRoot()) {
             $output->writeln('This command may need elevated privileges, and may prompt you for your password.');
         }
diff --git a/src/Downloading/DownloadUrlMethod.php b/src/Downloading/DownloadUrlMethod.php
index 397de170..6a5a95d8 100644
--- a/src/Downloading/DownloadUrlMethod.php
+++ b/src/Downloading/DownloadUrlMethod.php
@@ -10,6 +10,7 @@
 use Php\Pie\Platform\TargetPlatform;
 use Php\Pie\Platform\WindowsExtensionAssetName;
 
+/** @internal This is not public API for PIE, so should not be depended upon unless you accept the risk of BC breaks */
 enum DownloadUrlMethod: string
 {
     case ComposerDefaultDownload   = 'composer-default';
diff --git a/src/File/SudoCreate.php b/src/File/SudoCreate.php
index e7ba4899..9a58c003 100644
--- a/src/File/SudoCreate.php
+++ b/src/File/SudoCreate.php
@@ -13,6 +13,7 @@
 use function is_writable;
 use function touch;
 
+/** @internal This is not public API for PIE, so should not be depended upon unless you accept the risk of BC breaks */
 final class SudoCreate
 {
     public static function file(string $filename): void
diff --git a/src/File/SudoUnlink.php b/src/File/SudoUnlink.php
index 4f1bb542..1cfe33a6 100644
--- a/src/File/SudoUnlink.php
+++ b/src/File/SudoUnlink.php
@@ -4,6 +4,7 @@
 
 namespace Php\Pie\File;
 
+use Composer\Util\Platform;
 use Php\Pie\Util\CaptureErrors;
 use Php\Pie\Util\Process;
 use Symfony\Component\Process\Exception\ProcessFailedException;
@@ -12,6 +13,7 @@
 use function is_writable;
 use function unlink;
 
+/** @internal This is not public API for PIE, so should not be depended upon unless you accept the risk of BC breaks */
 final class SudoUnlink
 {
     public static function singleFile(string $filename): void
@@ -20,7 +22,7 @@ public static function singleFile(string $filename): void
             return;
         }
 
-        if (is_writable($filename)) {
+        if (! Platform::isWindows() && is_writable($filename)) {
             $capturedErrors   = [];
             $unlinkSuccessful = CaptureErrors::for(
                 static fn () => unlink($filename),
@@ -34,6 +36,12 @@ public static function singleFile(string $filename): void
             return;
         }
 
+        if (Platform::isWindows()) {
+            WindowsDelete::usingMoveToTemp($filename);
+
+            return;
+        }
+
         if (! Sudo::exists()) {
             throw FailedToUnlinkFile::fromNoPermissions($filename);
         }
diff --git a/src/File/WindowsDelete.php b/src/File/WindowsDelete.php
new file mode 100644
index 00000000..edae1ac5
--- /dev/null
+++ b/src/File/WindowsDelete.php
@@ -0,0 +1,47 @@
+<?php
+
+declare(strict_types=1);
+
+namespace Php\Pie\File;
+
+use Php\Pie\Util\Process;
+use RuntimeException;
+
+use function file_exists;
+use function sprintf;
+use function sys_get_temp_dir;
+use function tempnam;
+
+/** @internal This is not public API for PIE, so should not be depended upon unless you accept the risk of BC breaks */
+final class WindowsDelete
+{
+    /**
+     * Windows will hold a lock on the DLL, so we can't actually replace or
+     * delete the extension. However, Windows lets us move it out the way,
+     * so move it to the temp directory. It can then be cleaned up later.
+     */
+    public static function usingMoveToTemp(string $filename): void
+    {
+        if (! file_exists($filename)) {
+            return;
+        }
+
+        $newLockedExtFilename = tempnam(sys_get_temp_dir(), 'pie');
+        if ($newLockedExtFilename === false) {
+            throw new RuntimeException(sprintf(
+                'Failed to create a temporary name for moving %s',
+                $filename,
+            ));
+        }
+
+        Process::run(['move', $filename, $newLockedExtFilename]);
+
+        if (file_exists($filename)) {
+            throw new RuntimeException(sprintf(
+                'Failed to move %s to %s',
+                $filename,
+                $newLockedExtFilename,
+            ));
+        }
+    }
+}
diff --git a/src/Installing/Ini/RemoveIniEntryWithFileGetContents.php b/src/Installing/Ini/RemoveIniEntryWithFileGetContents.php
index 6b4235c5..8cc9bee9 100644
--- a/src/Installing/Ini/RemoveIniEntryWithFileGetContents.php
+++ b/src/Installing/Ini/RemoveIniEntryWithFileGetContents.php
@@ -60,7 +60,7 @@ static function (string $path) use ($additionalIniDirectory): bool {
         }
 
         $regex = sprintf(
-            '/^(%s\w*=\w*%s)/m',
+            '/^(%s\s*=\s*%s)/m',
             $package->extensionType() === ExtensionType::PhpModule ? 'extension' : 'zend_extension',
             $package->extensionName()->name(),
         );
diff --git a/src/Installing/WindowsInstall.php b/src/Installing/WindowsInstall.php
index 23c8f2a9..a97f0f54 100644
--- a/src/Installing/WindowsInstall.php
+++ b/src/Installing/WindowsInstall.php
@@ -5,8 +5,8 @@
 namespace Php\Pie\Installing;
 
 use Php\Pie\Downloading\DownloadedPackage;
-use Php\Pie\ExtensionType;
 use Php\Pie\File\BinaryFile;
+use Php\Pie\File\WindowsDelete;
 use Php\Pie\Platform\TargetPlatform;
 use Php\Pie\Platform\WindowsExtensionAssetName;
 use RecursiveDirectoryIterator;
@@ -21,7 +21,6 @@
 use function file_exists;
 use function is_file;
 use function mkdir;
-use function sprintf;
 use function str_replace;
 use function strlen;
 use function substr;
@@ -79,17 +78,6 @@ public function __invoke(
             $output->writeln('<info>Copied extras:</info> ' . $destinationPathname);
         }
 
-        /**
-         * @link https://github.com/php/pie/issues/20
-         *
-         * @todo this should be improved in future to try to automatically set up the ext
-         */
-        $output->writeln(sprintf(
-            '<comment>You must now add "%s=%s" to your php.ini</comment>',
-            $downloadedPackage->package->extensionType() === ExtensionType::PhpModule ? 'extension' : 'zend_extension',
-            $downloadedPackage->package->extensionName()->name(),
-        ));
-
         $binaryFile = BinaryFile::fromFileWithSha256Checksum($destinationDllName);
 
         ($this->setupIniFile)(
@@ -124,6 +112,10 @@ private function copyExtensionDll(TargetPlatform $targetPlatform, DownloadedPack
         $destinationDllName = $targetPlatform->phpBinaryPath->extensionPath() . DIRECTORY_SEPARATOR
             . 'php_' . $downloadedPackage->package->extensionName()->name() . '.dll';
 
+        if (file_exists($destinationDllName)) {
+            WindowsDelete::usingMoveToTemp($destinationDllName);
+        }
+
         if (! copy($sourceDllName, $destinationDllName) || ! file_exists($destinationDllName) && ! is_file($destinationDllName)) {
             throw new RuntimeException('Failed to install DLL to ' . $destinationDllName);
         }