diff --git a/examples/typescript-r4/fhir-types/hl7-fhir-r4-core/Reference.ts b/examples/typescript-r4/fhir-types/hl7-fhir-r4-core/Reference.ts
index f59d6fed..a3e6da73 100644
--- a/examples/typescript-r4/fhir-types/hl7-fhir-r4-core/Reference.ts
+++ b/examples/typescript-r4/fhir-types/hl7-fhir-r4-core/Reference.ts
@@ -13,7 +13,7 @@ export interface Reference<T extends string = string> extends Element {
     display?: string;
     _display?: Element;
     identifier?: Identifier;
-    reference?: `${T}/${string}`;
+    reference?: `${T}/${string}` | `http://${string}` | `https://${string}` | `urn:uuid:${string}` | `urn:oid:${string}` | `#${string}`;
     _reference?: Element;
     type?: string;
     _type?: Element;
diff --git a/examples/typescript-r4/resource.test.ts b/examples/typescript-r4/resource.test.ts
index 08f864e5..10b655f2 100644
--- a/examples/typescript-r4/resource.test.ts
+++ b/examples/typescript-r4/resource.test.ts
@@ -120,3 +120,18 @@ test("Bundle with resources", () => {
     expect(bundle.entry).toHaveLength(2);
     expect(bundle).toMatchSnapshot();
 });
+
+test("Reference accepts all FHIR literal reference forms", () => {
+    // Relative reference — still narrowed to the typed form
+    const relative: Observation["subject"] = { reference: "Patient/123" };
+    // Bundle placeholder — common in transaction bundles
+    const urnUuid: Observation["subject"] = { reference: "urn:uuid:a1b2c3d4-e5f6-7890-abcd-ef0123456789" };
+    // OID reference
+    const urnOid: Observation["subject"] = { reference: "urn:oid:2.16.840.1.113883.2.4.6.3" };
+    // Absolute URL
+    const absolute: Observation["subject"] = { reference: "https://example.org/fhir/Patient/123" };
+    // Fragment reference to a contained resource
+    const fragment: Observation["subject"] = { reference: "#contained-1" };
+
+    expect([relative, urnUuid, urnOid, absolute, fragment]).toHaveLength(5);
+});
diff --git a/examples/typescript-us-core/fhir-types/hl7-fhir-r4-core/Reference.ts b/examples/typescript-us-core/fhir-types/hl7-fhir-r4-core/Reference.ts
index f59d6fed..a3e6da73 100644
--- a/examples/typescript-us-core/fhir-types/hl7-fhir-r4-core/Reference.ts
+++ b/examples/typescript-us-core/fhir-types/hl7-fhir-r4-core/Reference.ts
@@ -13,7 +13,7 @@ export interface Reference<T extends string = string> extends Element {
     display?: string;
     _display?: Element;
     identifier?: Identifier;
-    reference?: `${T}/${string}`;
+    reference?: `${T}/${string}` | `http://${string}` | `https://${string}` | `urn:uuid:${string}` | `urn:oid:${string}` | `#${string}`;
     _reference?: Element;
     type?: string;
     _type?: Element;
diff --git a/src/api/writer-generator/typescript/utils.ts b/src/api/writer-generator/typescript/utils.ts
index 2f9414e5..a14f9b2c 100644
--- a/src/api/writer-generator/typescript/utils.ts
+++ b/src/api/writer-generator/typescript/utils.ts
@@ -54,7 +54,10 @@ export const tsEnumType = (enumDef: EnumDefinition) => {
 const rewriteFieldTypeDefs: Record<string, Record<string, () => string>> = {
     Coding: { code: () => "T" },
     // biome-ignore lint: that is exactly string what we want
-    Reference: { reference: () => "`${T}/${string}`" },
+    Reference: {
+        reference: () =>
+            "`${T}/${string}` | `http://${string}` | `https://${string}` | `urn:uuid:${string}` | `urn:oid:${string}` | `#${string}`",
+    },
     CodeableConcept: { coding: () => "Coding<T>" },
 };
 
diff --git a/src/fhir-types/hl7-fhir-r4-core/Reference.ts b/src/fhir-types/hl7-fhir-r4-core/Reference.ts
index 1ee03e7c..119ee2a0 100644
--- a/src/fhir-types/hl7-fhir-r4-core/Reference.ts
+++ b/src/fhir-types/hl7-fhir-r4-core/Reference.ts
@@ -12,6 +12,6 @@ export type { Identifier } from "../hl7-fhir-r4-core/Identifier";
 export interface Reference<T extends string = string> extends Element {
     display?: string;
     identifier?: Identifier;
-    reference?: `${T}/${string}`;
+    reference?: `${T}/${string}` | `http://${string}` | `https://${string}` | `urn:uuid:${string}` | `urn:oid:${string}` | `#${string}`;
     type?: string;
 }