diff --git a/monai/metrics/meaniou.py b/monai/metrics/meaniou.py
index 0ff4f131f8..f9be38b38a 100644
--- a/monai/metrics/meaniou.py
+++ b/monai/metrics/meaniou.py
@@ -152,16 +152,10 @@ def compute_iou(
     if y.shape != y_pred.shape:
         raise ValueError(f"y_pred and y should have same shapes, got {y_pred.shape} and {y.shape}.")
 
-    if ignore_index is not None and 0 <= ignore_index < (y_pred.shape[1] + (0 if include_background else 1)):
-        ignore_channel = ignore_index if include_background else ignore_index - 1
-        if 0 <= ignore_channel < y_pred.shape[1]:
-            y_pred = y_pred.clone()
-            y = y.clone()
-            y_pred[:, ignore_channel] = 0
-            y[:, ignore_channel] = 0
-        mask = None
-    else:
-        mask = create_ignore_mask(original_y if ignore_index is not None else y, ignore_index)
+    # Use the same spatial masking as DiceHelper so both metrics exclude the
+    # same voxels: zeroing the ignored channel alone would leave voxels of the
+    # ignored class counting as false positives for the other classes
+    mask = create_ignore_mask(original_y, ignore_index)
     if mask is not None:
         if mask.shape != y_pred.shape:
             mask = mask.expand_as(y_pred)
diff --git a/tests/metrics/test_ignore_index_metrics.py b/tests/metrics/test_ignore_index_metrics.py
index af5ffccee7..5353ab6618 100644
--- a/tests/metrics/test_ignore_index_metrics.py
+++ b/tests/metrics/test_ignore_index_metrics.py
@@ -24,6 +24,8 @@
     MeanIoU,
     SurfaceDiceMetric,
     SurfaceDistanceMetric,
+    compute_dice,
+    compute_iou,
 )
 from monai.utils import optional_import
 
@@ -142,6 +144,42 @@ def test_metric_ignore_class_index_without_background(self, metric_class, kwargs
 
         torch.testing.assert_close(res1, res2, msg=f"Failed for {metric_class.__name__}")
 
+    def test_ignored_voxels_excluded_from_other_classes(self):
+        """Ignored voxels must be dropped from every class score, not just their own."""
+        # 4 voxels, 3 one-hot classes; voxel 1 belongs to the ignored class 1
+        y = torch.tensor([[[1.0, 0.0, 0.0, 1.0], [0.0, 1.0, 0.0, 0.0], [0.0, 0.0, 1.0, 0.0]]])
+        # a perfect prediction except the ignored voxel is called class 0
+        y_pred = torch.tensor([[[1.0, 1.0, 0.0, 1.0], [0.0, 0.0, 0.0, 0.0], [0.0, 0.0, 1.0, 0.0]]])
+
+        iou = compute_iou(y_pred, y, include_background=True, ignore_index=1)
+        dice = compute_dice(y_pred, y, include_background=True, ignore_index=1)
+
+        # the mislabelled voxel is ignored, so class 0 is scored as perfect
+        self.assertEqual(iou[0, 0].item(), 1.0)
+        torch.testing.assert_close(iou, dice, equal_nan=True)
+
+    def test_ignored_voxels_excluded_with_include_background_false(self):
+        """The ignore_index mask must line up with the ignore_background channel strip."""
+        # 4 one-hot classes: 0=background, 1, 2=ignored, 3
+        y = torch.zeros(1, 4, 4)
+        y[0, 0, 0] = 1  # voxel 0 -> background
+        y[0, 2, 1] = 1  # voxel 1 -> ignored class
+        y[0, 1, 2] = 1  # voxel 2 -> class 1
+        y[0, 3, 3] = 1  # voxel 3 -> class 3
+
+        y_pred = y.clone()
+        # mislabel the ignored voxel as class 1 instead of leaving it unpredicted
+        y_pred[0, 2, 1] = 0
+        y_pred[0, 1, 1] = 1
+
+        iou = compute_iou(y_pred, y, include_background=False, ignore_index=2)
+        dice = compute_dice(y_pred, y, include_background=False, ignore_index=2)
+
+        # class 1's false positive at the ignored voxel must be dropped, not just
+        # its own (now background-stripped) channel
+        self.assertEqual(iou[0, 0].item(), 1.0)
+        torch.testing.assert_close(iou, dice, equal_nan=True)
+
 
 @unittest.skipUnless(has_scipy, "Scipy required for surface metrics")
 class TestIgnoreIndexSurfaceMetrics(unittest.TestCase):