diff --git a/changelog.d/9190.misc b/changelog.d/9190.misc
new file mode 100644
index 0000000000..1b0cc56a92
--- /dev/null
+++ b/changelog.d/9190.misc
@@ -0,0 +1 @@
+Improve performance of concurrent use of `StreamIDGenerators`.
diff --git a/synapse/storage/util/id_generators.py b/synapse/storage/util/id_generators.py
index bb84c0d792..71ef5a72dc 100644
--- a/synapse/storage/util/id_generators.py
+++ b/synapse/storage/util/id_generators.py
@@ -15,12 +15,11 @@
 import heapq
 import logging
 import threading
-from collections import deque
+from collections import OrderedDict
 from contextlib import contextmanager
 from typing import Dict, List, Optional, Set, Tuple, Union
 
 import attr
-from typing_extensions import Deque
 
 from synapse.metrics.background_process_metrics import run_as_background_process
 from synapse.storage.database import DatabasePool, LoggingTransaction
@@ -101,7 +100,13 @@ class StreamIdGenerator:
             self._current = (max if step > 0 else min)(
                 self._current, _load_current_id(db_conn, table, column, step)
             )
-        self._unfinished_ids = deque()  # type: Deque[int]
+
+        # We use this as an ordered set, as we want to efficiently append items,
+        # remove items and get the first item. Since we insert IDs in order, the
+        # insertion ordering will ensure its in the correct ordering.
+        #
+        # The key and values are the same, but we never look at the values.
+        self._unfinished_ids = OrderedDict()  # type: OrderedDict[int, int]
 
     def get_next(self):
         """
@@ -113,7 +118,7 @@ class StreamIdGenerator:
             self._current += self._step
             next_id = self._current
 
-            self._unfinished_ids.append(next_id)
+            self._unfinished_ids[next_id] = next_id
 
         @contextmanager
         def manager():
@@ -121,7 +126,7 @@ class StreamIdGenerator:
                 yield next_id
             finally:
                 with self._lock:
-                    self._unfinished_ids.remove(next_id)
+                    self._unfinished_ids.pop(next_id)
 
         return _AsyncCtxManagerWrapper(manager())
 
@@ -140,7 +145,7 @@ class StreamIdGenerator:
             self._current += n * self._step
 
             for next_id in next_ids:
-                self._unfinished_ids.append(next_id)
+                self._unfinished_ids[next_id] = next_id
 
         @contextmanager
         def manager():
@@ -149,7 +154,7 @@ class StreamIdGenerator:
             finally:
                 with self._lock:
                     for next_id in next_ids:
-                        self._unfinished_ids.remove(next_id)
+                        self._unfinished_ids.pop(next_id)
 
         return _AsyncCtxManagerWrapper(manager())
 
@@ -162,7 +167,7 @@ class StreamIdGenerator:
         """
         with self._lock:
             if self._unfinished_ids:
-                return self._unfinished_ids[0] - self._step
+                return next(iter(self._unfinished_ids)) - self._step
 
             return self._current