diff --git a/pcsx2/GS/Renderers/HW/GSTextureCache.cpp b/pcsx2/GS/Renderers/HW/GSTextureCache.cpp
index 6668defdeb0cc..1e480486576ff 100644
--- a/pcsx2/GS/Renderers/HW/GSTextureCache.cpp
+++ b/pcsx2/GS/Renderers/HW/GSTextureCache.cpp
@@ -1722,7 +1722,19 @@ GSTextureCache::Target* GSTextureCache::LookupTarget(GIFRegTEX0 TEX0, const GSVe
 					}
 				}
 
-				if (can_use && !is_shuffle && preserve_alpha && preserve_rgb && TEX0.TBW != t->m_TEX0.TBW && t->m_dirty.size() >= 1)
+				// TODO: What might be a nicer solution than this, is to rearrange the targets to match the new layout, however this comes with some caviets:
+				// 1. They can draw wider than the FBW
+				// 2. The dirty+valid rects will need to also be rearranged
+				// 3. This could mean larger targets hanging around more
+				// 4. Sources which reference a target may become invalid and will need to be removed
+				// 5. Potential performance implications from additional render passes/copying
+				//
+				// But the bonuses are:
+				// 1. Rearranging the page layout will fix quite a few games which do this
+				// 2. Preserved data will be in the correct place (in most cases)
+				// 3. Less deleting sources/targets
+				// 4. We can basically do clears in hardware, if they aren't insane ones
+				if (can_use && !is_shuffle && ((preserve_alpha && preserve_rgb) || (size.y > GSLocalMemory::m_psm[t->m_TEX0.PSM].pgs.y && !possible_clear)) && TEX0.TBW != t->m_TEX0.TBW && t->m_dirty.size() >= 1)
 				{
 					can_use = false;
 				}