diff --git a/AUTHORS b/AUTHORS
index 27c0b3ac408..972f39aa45e 100644
--- a/AUTHORS
+++ b/AUTHORS
@@ -334,6 +334,7 @@ Mike Fiedler (miketheman)
 Mike Hoyle (hoylemd)
 Mike Lundy
 Milan Lesnek
+minbang930
 Miro Hrončok
 Mulat Mekonen
 mrbean-bremen
diff --git a/changelog/14533.breaking.rst b/changelog/14533.breaking.rst
new file mode 100644
index 00000000000..d63f4d3a852
--- /dev/null
+++ b/changelog/14533.breaking.rst
@@ -0,0 +1,8 @@
+When using :option:`--doctest-modules`, autouse fixtures with ``module``, ``package`` or ``session`` scope that are defined inline in Python test modules (not plugins or conftests) will now possibly execute twice.
+
+If this is undesirable, move the fixture definition to a ``conftest.py`` file if possible.
+
+Technical explanation for those interested:
+When using `--doctest-modules`, pytest possibly collects Python modules twice, once as :class:`pytest.Module` and once as a ``DoctestModule`` (depending on the configuration).
+Due to improvements in pytest's fixture implementation, if e.g. the ``DoctestModule`` collects a fixture, it is now visible to it only, and not to the ``Module``.
+This means that both need to register the fixtures independently.
diff --git a/doc/en/how-to/doctest.rst b/doc/en/how-to/doctest.rst
index 9bbe750bc4a..9375a279ea5 100644
--- a/doc/en/how-to/doctest.rst
+++ b/doc/en/how-to/doctest.rst
@@ -42,7 +42,7 @@ By default, pytest will collect ``test*.txt`` files looking for doctest directiv
 can pass additional globs using the :option:`--doctest-glob` option (multi-allowed).
 
 In addition to text files, you can also execute doctests directly from docstrings of your classes
-and functions, including from test modules:
+and functions, including from test modules, using the :option:`--doctest-modules` option:
 
 .. code-block:: python
 
@@ -224,6 +224,9 @@ unless explicitly configured by :confval:`python_files`.
 Also, the :ref:`usefixtures <usefixtures>` mark and fixtures marked as :ref:`autouse <autouse>` are supported
 when executing text doctest files.
 
+Python doctest modules are collected independently from Python test files.
+Fixture scope is not shared between the two.
+
 Doctests do not support fixtures that depend on parametrization, because doctest
 collection does not perform the same test generation as normal test functions.
 This includes parametrized autouse fixtures. If you need to run doctests against
diff --git a/pyproject.toml b/pyproject.toml
index cce08575ce1..d40a74cc78a 100644
--- a/pyproject.toml
+++ b/pyproject.toml
@@ -377,6 +377,7 @@ testpaths = [
 ]
 norecursedirs = [
     "testing/example_scripts",
+    "testing/plugins_integration",
     ".*",
     "build",
     "dist",
diff --git a/src/_pytest/doctest.py b/src/_pytest/doctest.py
index cd255f5eeb6..b1f365109ba 100644
--- a/src/_pytest/doctest.py
+++ b/src/_pytest/doctest.py
@@ -552,8 +552,7 @@ def _from_module(self, module, object):
             else:
                 raise
 
-        # While doctests currently don't support fixtures directly, we still
-        # need to pick up autouse fixtures.
+        # doctests supports fixtures via `getfixture` and autouse.
         self.session._fixturemanager.parsefactories(self)
 
         # Uses internal doctest module parsing mechanism.
diff --git a/src/_pytest/fixtures.py b/src/_pytest/fixtures.py
index cbff9455e9d..e787b323362 100644
--- a/src/_pytest/fixtures.py
+++ b/src/_pytest/fixtures.py
@@ -1707,7 +1707,6 @@ def __init__(self, session: Session) -> None:
         # TODO: The order of the FixtureDefs list of each arg is significant,
         #       explain.
         self._arg2fixturedefs: Final[dict[str, list[FixtureDef[Any]]]] = {}
-        self._holderobjseen: Final[set[object]] = set()
         # A mapping from a node to a list of autouse fixture names it defines.
         # The Session entry holds global usefixtures from config.
         self._node_autousenames: Final[dict[nodes.Node, list[str]]] = {
@@ -2070,8 +2069,6 @@ def parsefactories(
             assert isinstance(node_or_obj, nodes.Node)
             holderobj = cast(object, node_or_obj.obj)  # type: ignore[attr-defined]
             effective_node = node_or_obj
-        if holderobj in self._holderobjseen:
-            return
 
         # Avoid accessing `@property` (and other descriptors) when iterating fixtures.
         if not safe_isclass(holderobj) and not isinstance(holderobj, types.ModuleType):
@@ -2079,7 +2076,6 @@ def parsefactories(
         else:
             holderobj_tp = holderobj
 
-        self._holderobjseen.add(holderobj)
         for name in dir(holderobj):
             # The attribute can be an arbitrary descriptor, so the attribute
             # access below can raise. safe_getattr() ignores such exceptions.
diff --git a/testing/test_doctest.py b/testing/test_doctest.py
index 8b71dabbc77..9c788d0fc41 100644
--- a/testing/test_doctest.py
+++ b/testing/test_doctest.py
@@ -600,6 +600,37 @@ def test_doctestmodule_with_fixtures(self, pytester: Pytester):
         reprec = pytester.inline_run(p, "--doctest-modules")
         reprec.assertoutcome(passed=1)
 
+    def test_module_fixture_available_to_normal_test_with_doctestmodules(
+        self, pytester: Pytester
+    ) -> None:
+        """Regression test for #14533.
+
+        Module-level fixtures collected with ``--doctest-modules`` are available
+        both to normal tests and doctests in the same file.
+        """
+        pytester.makepyfile(
+            """
+            import pytest
+
+            @pytest.fixture
+            def fix():
+                return "fix"
+
+            def test(fix):
+                assert fix == "fix"
+
+            def func():
+                '''My function.
+
+                >>> getfixture("fix")
+                'fix'
+                '''
+            """
+        )
+
+        result = pytester.runpytest("--doctest-modules")
+        result.assert_outcomes(passed=2)
+
     def test_doctestmodule_three_tests(self, pytester: Pytester):
         p = pytester.makepyfile(
             """
@@ -1302,6 +1333,37 @@ def bar():
         result = pytester.runpytest("--doctest-modules")
         result.stdout.fnmatch_lines(["*2 passed*"])
 
+    def test_doctest_and_python_fixtures_not_shared(self, pytester: Pytester) -> None:
+        """Fixture scopes are not shared between doctest and python modules.
+
+        This test is not meant as a hard behavioral test -- sharing scope is
+        also an acceptable behavior (see #14533). But this test ensures and
+        behavior change is done knowingly.
+        """
+        pytester.makepyfile(
+            r"""
+            import pytest
+
+            @pytest.fixture(scope="session", autouse=True)
+            def auto():
+                with open("out", "a", encoding="utf-8") as f:
+                    f.write("RUN\n")
+
+            def test():
+                pass
+
+            def func():
+                '''My function.
+
+                >>> 1 + 1
+                2
+                '''
+        """
+        )
+        result = pytester.runpytest("--doctest-modules")
+        result.assert_outcomes(passed=2)
+        assert Path("out").read_text("utf-8").split() == ["RUN"] * 2
+
     @pytest.mark.parametrize("scope", SCOPES)
     @pytest.mark.parametrize("enable_doctest", [True, False])
     def test_fixture_scopes(self, pytester, scope, enable_doctest):
diff --git a/tox.ini b/tox.ini
index b37bdb6aa85..89faf448875 100644
--- a/tox.ini
+++ b/tox.ini
@@ -182,6 +182,7 @@ description =
 pip_pre=true
 changedir = testing/plugins_integration
 deps = -rtesting/plugins_integration/requirements.txt
+allowlist_externals = pip
 setenv =
     PYTHONPATH=.
 commands =