diff --git a/mypyc/lib-rt/CPy.h b/mypyc/lib-rt/CPy.h
index c22c4162669b..458db90efd53 100644
--- a/mypyc/lib-rt/CPy.h
+++ b/mypyc/lib-rt/CPy.h
@@ -664,16 +664,68 @@ PyObject *CPyObject_GetSlice(PyObject *obj, CPyTagged start, CPyTagged end);
 // List operations
 
 
-PyObject *CPyList_Build(Py_ssize_t len, ...);
+#ifndef Py_GIL_DISABLED
+
 PyObject *CPyList_GetItem(PyObject *list, CPyTagged index);
 PyObject *CPyList_GetItemShort(PyObject *list, CPyTagged index);
+PyObject *CPyList_GetItemInt64(PyObject *list, int64_t index);
+bool CPyList_SetItem(PyObject *list, CPyTagged index, PyObject *value);
+bool CPyList_SetItemInt64(PyObject *list, int64_t index, PyObject *value);
+
+#else
+
+PyObject *CPyList_GetItem_(PyObject *list, CPyTagged index);
+bool CPyList_SetItem_(PyObject *list, CPyTagged index, PyObject *value);
+
+static inline PyObject *CPyList_GetItem(PyObject *list, CPyTagged index) {
+    if (likely(CPyTagged_CheckShort(index) && !CPyTagged_IsNegative(index))) {
+        // Inlined fast path
+        Py_ssize_t n = CPyTagged_ShortAsSsize_t(index);
+        return PyList_GetItemRef(list, n);
+    } else {
+        return CPyList_GetItem_(list, index);
+    }
+}
+
+static inline PyObject *CPyList_GetItemShort(PyObject *list, CPyTagged index) {
+    Py_ssize_t n = CPyTagged_ShortAsSsize_t(index);
+    if (n < 0) {
+        n += PyList_GET_SIZE(list);
+    }
+    return PyList_GetItemRef(list, n);
+}
+
+static inline PyObject *CPyList_GetItemInt64(PyObject *list, int64_t index) {
+    if (index < 0) {
+        index += PyList_GET_SIZE(list);
+    }
+    return PyList_GetItemRef(list, index);
+}
+
+static inline bool CPyList_SetItem(PyObject *list, CPyTagged index, PyObject *value) {
+    if (likely(CPyTagged_CheckShort(index) && !CPyTagged_IsNegative(index))) {
+        // Inlined fast path
+        Py_ssize_t n = CPyTagged_ShortAsSsize_t(index);
+        return PyList_SetItem(list, n, value) >= 0;
+    } else {
+        return CPyList_SetItem_(list, index, value);
+    }
+}
+
+static inline bool CPyList_SetItemInt64(PyObject *list, int64_t index, PyObject *value) {
+    if (index < 0) {
+        index += PyList_GET_SIZE(list);
+    }
+    return PyList_SetItem(list, index, value) >= 0;
+}
+
+#endif
+
 PyObject *CPyList_GetItemBorrow(PyObject *list, CPyTagged index);
 PyObject *CPyList_GetItemShortBorrow(PyObject *list, CPyTagged index);
-PyObject *CPyList_GetItemInt64(PyObject *list, int64_t index);
 PyObject *CPyList_GetItemInt64Borrow(PyObject *list, int64_t index);
-bool CPyList_SetItem(PyObject *list, CPyTagged index, PyObject *value);
 void CPyList_SetItemUnsafe(PyObject *list, Py_ssize_t index, PyObject *value);
-bool CPyList_SetItemInt64(PyObject *list, int64_t index, PyObject *value);
+PyObject *CPyList_Build(Py_ssize_t len, ...);
 PyObject *CPyList_PopLast(PyObject *obj);
 PyObject *CPyList_Pop(PyObject *obj, CPyTagged index);
 CPyTagged CPyList_Count(PyObject *obj, PyObject *value);
diff --git a/mypyc/lib-rt/list_ops.c b/mypyc/lib-rt/list_ops.c
index 8b7eaa1acf3f..e8fd061ada68 100644
--- a/mypyc/lib-rt/list_ops.c
+++ b/mypyc/lib-rt/list_ops.c
@@ -49,6 +49,8 @@ PyObject *CPyList_Copy(PyObject *list) {
     return PyObject_CallMethodNoArgs(list, mypyc_interned_str.copy);
 }
 
+#ifndef Py_GIL_DISABLED
+
 PyObject *CPyList_GetItemShort(PyObject *list, CPyTagged index) {
     Py_ssize_t n = CPyTagged_ShortAsSsize_t(index);
     Py_ssize_t size = PyList_GET_SIZE(list);
@@ -69,24 +71,6 @@ PyObject *CPyList_GetItemShort(PyObject *list, CPyTagged index) {
     return result;
 }
 
-PyObject *CPyList_GetItemShortBorrow(PyObject *list, CPyTagged index) {
-    Py_ssize_t n = CPyTagged_ShortAsSsize_t(index);
-    Py_ssize_t size = PyList_GET_SIZE(list);
-    if (n >= 0) {
-        if (n >= size) {
-            PyErr_SetString(PyExc_IndexError, "list index out of range");
-            return NULL;
-        }
-    } else {
-        n += size;
-        if (n < 0) {
-            PyErr_SetString(PyExc_IndexError, "list index out of range");
-            return NULL;
-        }
-    }
-    return PyList_GET_ITEM(list, n);
-}
-
 PyObject *CPyList_GetItem(PyObject *list, CPyTagged index) {
     if (CPyTagged_CheckShort(index)) {
         Py_ssize_t n = CPyTagged_ShortAsSsize_t(index);
@@ -112,29 +96,6 @@ PyObject *CPyList_GetItem(PyObject *list, CPyTagged index) {
     }
 }
 
-PyObject *CPyList_GetItemBorrow(PyObject *list, CPyTagged index) {
-    if (CPyTagged_CheckShort(index)) {
-        Py_ssize_t n = CPyTagged_ShortAsSsize_t(index);
-        Py_ssize_t size = PyList_GET_SIZE(list);
-        if (n >= 0) {
-            if (n >= size) {
-                PyErr_SetString(PyExc_IndexError, "list index out of range");
-                return NULL;
-            }
-        } else {
-            n += size;
-            if (n < 0) {
-                PyErr_SetString(PyExc_IndexError, "list index out of range");
-                return NULL;
-            }
-        }
-        return PyList_GET_ITEM(list, n);
-    } else {
-        PyErr_SetString(PyExc_OverflowError, CPYTHON_LARGE_INT_ERRMSG);
-        return NULL;
-    }
-}
-
 PyObject *CPyList_GetItemInt64(PyObject *list, int64_t index) {
     size_t size = PyList_GET_SIZE(list);
     if (likely((uint64_t)index < size)) {
@@ -156,23 +117,6 @@ PyObject *CPyList_GetItemInt64(PyObject *list, int64_t index) {
     return result;
 }
 
-PyObject *CPyList_GetItemInt64Borrow(PyObject *list, int64_t index) {
-    size_t size = PyList_GET_SIZE(list);
-    if (likely((uint64_t)index < size)) {
-        return PyList_GET_ITEM(list, index);
-    }
-    if (index >= 0) {
-        PyErr_SetString(PyExc_IndexError, "list index out of range");
-        return NULL;
-    }
-    index += size;
-    if (index < 0) {
-        PyErr_SetString(PyExc_IndexError, "list index out of range");
-        return NULL;
-    }
-    return PyList_GET_ITEM(list, index);
-}
-
 bool CPyList_SetItem(PyObject *list, CPyTagged index, PyObject *value) {
     if (CPyTagged_CheckShort(index)) {
         Py_ssize_t n = CPyTagged_ShortAsSsize_t(index);
@@ -220,6 +164,95 @@ bool CPyList_SetItemInt64(PyObject *list, int64_t index, PyObject *value) {
     return true;
 }
 
+#else /* Py_GIL_DISABLED */
+
+PyObject *CPyList_GetItem_(PyObject *list, CPyTagged index) {
+    if (CPyTagged_CheckShort(index)) {
+        Py_ssize_t n = CPyTagged_ShortAsSsize_t(index);
+        if (n < 0) {
+            n += PyList_GET_SIZE(list);
+        }
+        return PyList_GetItemRef(list, n);
+    } else {
+        PyErr_SetString(PyExc_OverflowError, CPYTHON_LARGE_INT_ERRMSG);
+        return NULL;
+    }
+}
+
+bool CPyList_SetItem_(PyObject *list, CPyTagged index, PyObject *value) {
+    if (CPyTagged_CheckShort(index)) {
+        Py_ssize_t n = CPyTagged_ShortAsSsize_t(index);
+        Py_ssize_t size = PyList_GET_SIZE(list);
+        if (n < 0) {
+            n += size;
+        }
+        return PyList_SetItem(list, n, value) >= 0;
+    } else {
+        PyErr_SetString(PyExc_OverflowError, CPYTHON_LARGE_INT_ERRMSG);
+        return false;
+    }
+}
+
+#endif
+
+PyObject *CPyList_GetItemShortBorrow(PyObject *list, CPyTagged index) {
+    Py_ssize_t n = CPyTagged_ShortAsSsize_t(index);
+    Py_ssize_t size = PyList_GET_SIZE(list);
+    if (n >= 0) {
+        if (n >= size) {
+            PyErr_SetString(PyExc_IndexError, "list index out of range");
+            return NULL;
+        }
+    } else {
+        n += size;
+        if (n < 0) {
+            PyErr_SetString(PyExc_IndexError, "list index out of range");
+            return NULL;
+        }
+    }
+    return PyList_GET_ITEM(list, n);
+}
+
+PyObject *CPyList_GetItemBorrow(PyObject *list, CPyTagged index) {
+    if (CPyTagged_CheckShort(index)) {
+        Py_ssize_t n = CPyTagged_ShortAsSsize_t(index);
+        Py_ssize_t size = PyList_GET_SIZE(list);
+        if (n >= 0) {
+            if (n >= size) {
+                PyErr_SetString(PyExc_IndexError, "list index out of range");
+                return NULL;
+            }
+        } else {
+            n += size;
+            if (n < 0) {
+                PyErr_SetString(PyExc_IndexError, "list index out of range");
+                return NULL;
+            }
+        }
+        return PyList_GET_ITEM(list, n);
+    } else {
+        PyErr_SetString(PyExc_OverflowError, CPYTHON_LARGE_INT_ERRMSG);
+        return NULL;
+    }
+}
+
+PyObject *CPyList_GetItemInt64Borrow(PyObject *list, int64_t index) {
+    size_t size = PyList_GET_SIZE(list);
+    if (likely((uint64_t)index < size)) {
+        return PyList_GET_ITEM(list, index);
+    }
+    if (index >= 0) {
+        PyErr_SetString(PyExc_IndexError, "list index out of range");
+        return NULL;
+    }
+    index += size;
+    if (index < 0) {
+        PyErr_SetString(PyExc_IndexError, "list index out of range");
+        return NULL;
+    }
+    return PyList_GET_ITEM(list, index);
+}
+
 // This function should only be used to fill in brand new lists.
 void CPyList_SetItemUnsafe(PyObject *list, Py_ssize_t index, PyObject *value) {
     PyList_SET_ITEM(list, index, value);
diff --git a/mypyc/lib-rt/mypyc_util.h b/mypyc/lib-rt/mypyc_util.h
index 4a4552d059b8..d7a3eb3214be 100644
--- a/mypyc/lib-rt/mypyc_util.h
+++ b/mypyc/lib-rt/mypyc_util.h
@@ -156,6 +156,10 @@ static inline CPyTagged CPyTagged_ShortFromSsize_t(Py_ssize_t x) {
     return x << 1;
 }
 
+static inline int CPyTagged_IsNegative(CPyTagged x) {
+    return ((Py_ssize_t)x) < 0;
+}
+
 // Are we targeting Python 3.X or newer?
 #define CPY_3_11_FEATURES (PY_VERSION_HEX >= 0x030b0000)
 #define CPY_3_12_FEATURES (PY_VERSION_HEX >= 0x030c0000)
diff --git a/mypyc/test-data/run-lists.test b/mypyc/test-data/run-lists.test
index 40ca1b6e005f..d06fc9ce10b0 100644
--- a/mypyc/test-data/run-lists.test
+++ b/mypyc/test-data/run-lists.test
@@ -171,6 +171,68 @@ def test_list_build() -> None:
     l3.append('a')
     assert l3 == ['a']
 
+class C:
+    def __init__(self, s: str) -> None:
+        self.s = s
+
+a = [C("a"), C("b"), C("c")]
+
+def test_get_item() -> None:
+    zero = int()
+    assert a[zero].s == "a"
+    assert a[zero + 1].s == "b"
+    assert a[zero + 2].s == "c"
+    assert a[zero - 1].s == "c"
+    assert a[zero - 2].s == "b"
+    assert a[zero - 3].s == "a"
+    with assertRaises(IndexError):
+        a[zero + 3]
+    with assertRaises(IndexError):
+        a[zero - 4]
+    # TODO: Raise IndexError?
+    with assertRaises(OverflowError):
+        a[zero + 2**90]
+    with assertRaises(OverflowError):
+        a[zero - 2**90]
+
+def test_get_item_literal() -> None:
+    assert a[0].s == "a"
+    assert a[1].s == "b"
+    assert a[2].s == "c"
+    assert a[-1].s == "c"
+    assert a[-2].s == "b"
+    assert a[-3].s == "a"
+    with assertRaises(IndexError):
+        a[3]
+    with assertRaises(IndexError):
+        a[-4]
+    # TODO: Raise IndexError?
+    with assertRaises(OverflowError):
+        a[2**90]
+    with assertRaises(OverflowError):
+        a[-2**90]
+
+def test_set_item() -> None:
+    l = a.copy()
+    zero = int()
+    zero2 = int()
+    l[zero] = C("x")
+    assert l[zero2].s == "x"
+    l[zero + 2] = C("y")
+    assert l[zero2 + 2].s == "y"
+    l[zero - 1] = C("t")
+    assert l[zero2 - 1].s == "t"
+    l[zero - 3] = C("u")
+    assert l[zero2 - 3].s == "u"
+    with assertRaises(IndexError):
+        a[zero + 3] = C("z")
+    with assertRaises(IndexError):
+        a[zero - 4] = C("z")
+    with assertRaises(OverflowError):
+        a[zero + 2**90] = C("z")
+    with assertRaises(OverflowError):
+        a[zero - 2**90] = C("z")
+
 def test_append() -> None:
     l = [1, 2]
     l.append(10)