diff --git a/docling_serve/otel_instrumentation.py b/docling_serve/otel_instrumentation.py
index a3a30d2..f917caa 100644
--- a/docling_serve/otel_instrumentation.py
+++ b/docling_serve/otel_instrumentation.py
@@ -115,9 +115,16 @@ def setup_otel_instrumentation(
             )
             metrics.set_meter_provider(meter_provider)
 
-    # Instrument FastAPI
-    logger.info("Instrumenting FastAPI with OpenTelemetry")
-    FastAPIInstrumentor.instrument_app(app)
+    # Instrument FastAPI - use excluded_urls to suppress both traces AND metrics
+    # for health/readiness/metrics endpoints. The custom sampler above only filters
+    # trace spans
+    # Patterns are anchored with $ to avoid matching substrings like /healthcheck.
+    excluded_urls = ",".join(f"{p}$" for p in FILTERED_PATHS)
+    logger.info(
+        "Instrumenting FastAPI with OpenTelemetry (excluded_urls=%s)",
+        excluded_urls,
+    )
+    FastAPIInstrumentor.instrument_app(app, excluded_urls=excluded_urls)
 
     # Register RQ metrics if Redis URL is provided
     if redis_url and enable_prometheus:
diff --git a/tests/test_otel_filtering.py b/tests/test_otel_filtering.py
new file mode 100644
index 0000000..240b8ff
--- /dev/null
+++ b/tests/test_otel_filtering.py
@@ -0,0 +1,203 @@
+"""Tests for OpenTelemetry trace filtering of health and metrics endpoints."""
+
+from unittest.mock import MagicMock, patch
+
+import pytest
+from opentelemetry.sdk.trace.sampling import Decision
+from opentelemetry.trace import SpanKind
+from opentelemetry.util.http import ExcludeList
+
+from docling_serve.otel_instrumentation import (
+    FILTERED_PATHS,
+    HealthMetricsFilterSampler,
+    setup_otel_instrumentation,
+)
+
+
+@pytest.fixture
+def sampler():
+    """Create a HealthMetricsFilterSampler instance."""
+    return HealthMetricsFilterSampler()
+
+
+class TestHealthMetricsFilterSampler:
+    """Test the HealthMetricsFilterSampler."""
+
+    @pytest.mark.parametrize(
+        "path",
+        [
+            "/metrics",
+            "/health",
+            "/healthz",
+            "/readyz",
+            "/livez",
+        ],
+    )
+    def test_filtered_paths_are_dropped(self, sampler, path):
+        """Test that health and metrics endpoints are filtered out."""
+        parent_context = MagicMock()
+        trace_id = 12345
+        name = f"GET {path}"
+        attributes = {"http.target": path}
+
+        result = sampler.should_sample(
+            parent_context=parent_context,
+            trace_id=trace_id,
+            name=name,
+            kind=SpanKind.SERVER,
+            attributes=attributes,
+        )
+
+        assert result.decision == Decision.DROP
+
+    @pytest.mark.parametrize(
+        "path",
+        [
+            "/metrics?verbose=true",
+            "/health?check=all",
+            "/healthz?detailed=1",
+            "/readyz?wait=5",
+            "/livez?format=json",
+        ],
+    )
+    def test_filtered_paths_with_query_params_are_dropped(self, sampler, path):
+        """Test that filtered endpoints with query params are still dropped."""
+        parent_context = MagicMock()
+        trace_id = 12345
+        name = f"GET {path.split('?')[0]}"
+        attributes = {"http.target": path}
+
+        result = sampler.should_sample(
+            parent_context=parent_context,
+            trace_id=trace_id,
+            name=name,
+            kind=SpanKind.SERVER,
+            attributes=attributes,
+        )
+
+        assert result.decision == Decision.DROP
+
+    @pytest.mark.parametrize(
+        "path",
+        [
+            "/",
+            "/v1/documents",
+            "/v1/convert",
+            "/api/health",  # Different path
+            "/healthcheck",  # Different path
+            "/docs",
+        ],
+    )
+    def test_other_paths_are_sampled(self, sampler, path):
+        """Test that other endpoints are sampled normally."""
+        parent_context = MagicMock()
+        trace_id = 12345
+        name = f"GET {path}"
+        attributes = {"http.target": path}
+
+        result = sampler.should_sample(
+            parent_context=parent_context,
+            trace_id=trace_id,
+            name=name,
+            kind=SpanKind.SERVER,
+            attributes=attributes,
+        )
+
+        assert result.decision == Decision.RECORD_AND_SAMPLE
+
+    def test_missing_http_target_attribute_is_sampled(self, sampler):
+        """Test that spans without http.target are sampled."""
+        parent_context = MagicMock()
+        trace_id = 12345
+        name = "some_operation"
+        attributes = {"other.attribute": "value"}
+
+        result = sampler.should_sample(
+            parent_context=parent_context,
+            trace_id=trace_id,
+            name=name,
+            kind=SpanKind.INTERNAL,
+            attributes=attributes,
+        )
+
+        assert result.decision == Decision.RECORD_AND_SAMPLE
+
+    def test_no_attributes_is_sampled(self, sampler):
+        """Test that spans without attributes are sampled."""
+        parent_context = MagicMock()
+        trace_id = 12345
+        name = "some_operation"
+
+        result = sampler.should_sample(
+            parent_context=parent_context,
+            trace_id=trace_id,
+            name=name,
+            kind=SpanKind.INTERNAL,
+            attributes=None,
+        )
+
+        assert result.decision == Decision.RECORD_AND_SAMPLE
+
+    def test_filtered_paths_constant(self):
+        """Test that FILTERED_PATHS contains expected endpoints."""
+        expected_paths = {"/metrics", "/health", "/healthz", "/readyz", "/livez"}
+        assert FILTERED_PATHS == expected_paths
+
+
+class TestExcludedUrlsIntegration:
+    """Test that setup_otel_instrumentation passes excluded_urls to FastAPIInstrumentor."""
+
+    @patch("docling_serve.otel_instrumentation.FastAPIInstrumentor")
+    def test_excluded_urls_passed_to_instrumentor(self, mock_instrumentor_cls):
+        """Verify that FILTERED_PATHS are passed as excluded_urls to instrument_app."""
+        app = MagicMock()
+
+        setup_otel_instrumentation(
+            app,
+            enable_metrics=False,
+            enable_traces=False,
+        )
+
+        mock_instrumentor_cls.instrument_app.assert_called_once()
+        call_kwargs = mock_instrumentor_cls.instrument_app.call_args
+        assert call_kwargs[0][0] is app
+        excluded = call_kwargs[1]["excluded_urls"]
+        for path in FILTERED_PATHS:
+            assert f"{path}$" in excluded
+
+    @patch("docling_serve.otel_instrumentation.FastAPIInstrumentor")
+    def test_excluded_urls_is_comma_separated_anchored(self, mock_instrumentor_cls):
+        """Verify excluded_urls is comma-separated, $-anchored FILTERED_PATHS."""
+        app = MagicMock()
+
+        setup_otel_instrumentation(
+            app,
+            enable_metrics=False,
+            enable_traces=False,
+        )
+
+        call_kwargs = mock_instrumentor_cls.instrument_app.call_args
+        excluded = call_kwargs[1]["excluded_urls"]
+        parts = {p.strip() for p in excluded.split(",")}
+        assert parts == {f"{p}$" for p in FILTERED_PATHS}
+
+    @pytest.mark.parametrize(
+        "path,should_exclude",
+        [
+            ("/health", True),
+            ("/metrics", True),
+            ("/healthz", True),
+            ("/readyz", True),
+            ("/livez", True),
+            ("/v1/convert", False),
+            ("/v1/documents", False),
+            ("/docs", False),
+            ("/healthcheck", False),
+        ],
+    )
+    def test_excluded_urls_regex_matching(self, path, should_exclude):
+        """Verify the ExcludeList built from FILTERED_PATHS matches expected URLs."""
+        excluded_urls = ",".join(f"{p}$" for p in FILTERED_PATHS)
+        exclude_list = ExcludeList(excluded_urls.split(","))
+        url = f"http://localhost:5001{path}"
+        assert exclude_list.url_disabled(url) == should_exclude