diff --git a/flask_pymongo/__init__.py b/flask_pymongo/__init__.py
index a27abb5..1737505 100644
--- a/flask_pymongo/__init__.py
+++ b/flask_pymongo/__init__.py
@@ -27,6 +27,7 @@
 __all__ = ("PyMongo", "ASCENDING", "DESCENDING", "BSONObjectIdConverter", "BSONProvider")
 
 import hashlib
+import warnings
 from mimetypes import guess_type
 from typing import Any
 
@@ -183,12 +184,24 @@ def get_upload(filename):
         response.headers["Content-Disposition"] = f"attachment; filename={filename}"
         response.content_length = fileobj.length
         response.last_modified = fileobj.upload_date
-        # Compute the sha1 sum of the file for the etag.
-        pos = fileobj.tell()
-        raw_data = fileobj.read()
-        fileobj.seek(pos)
-        digest = hashlib.sha1(raw_data).hexdigest()
-        response.set_etag(digest)
+
+        # GridFS does not manage its own checksum.
+        # Try to use a sha1 sum that we have added during a save_file.
+        # Fall back to a legacy md5 sum if it exists.
+        # Otherwise, compute the sha1 sum directly.
+        try:
+            etag = fileobj.sha1
+        except AttributeError:
+            with warnings.catch_warnings():
+                warnings.simplefilter("ignore")
+                etag = fileobj.md5
+            if etag is None:
+                pos = fileobj.tell()
+                raw_data = fileobj.read()
+                fileobj.seek(pos)
+                etag = hashlib.sha1(raw_data).hexdigest()
+        response.set_etag(etag)
+
         response.cache_control.max_age = cache_for
         response.cache_control.public = True
         response.make_conditional(request)
@@ -237,5 +250,23 @@ def save_upload(filename):
             db_obj = self.db
         assert db_obj is not None, "Please initialize the app before calling save_file!"
         storage = GridFS(db_obj, base)
-        id = storage.put(fileobj, filename=filename, content_type=content_type, **kwargs)
-        return id
+
+        # GridFS does not manage its own checksum, so we attach a sha1 to the file
+        # for use as an etag.
+        hashingfile = _Wrapper(fileobj)
+        with storage.new_file(filename=filename, content_type=content_type, **kwargs) as grid_file:
+            grid_file.write(hashingfile)
+            grid_file.sha1 = hashingfile.hash.hexdigest()
+            return grid_file._id
+
+
+class _Wrapper:
+    def __init__(self, file):
+        self.file = file
+        self.hash = hashlib.sha1()
+
+    def read(self, n):
+        data = self.file.read(n)
+        if data:
+            self.hash.update(data)
+        return data
diff --git a/tests/test_gridfs.py b/tests/test_gridfs.py
index ee6b6e3..8e8bf10 100644
--- a/tests/test_gridfs.py
+++ b/tests/test_gridfs.py
@@ -1,6 +1,7 @@
 from __future__ import annotations
 
-from hashlib import sha1
+import warnings
+from hashlib import md5, sha1
 from io import BytesIO
 
 import pytest
@@ -95,6 +96,26 @@ def test_it_sets_supports_conditional_gets(self):
             resp = self.mongo.send_file("myfile.txt")
             assert resp.status_code == 304
 
+    def test_it_sets_supports_conditional_gets_md5(self):
+        # a basic conditional GET
+        md5_hash = md5(self.myfile.getvalue()).hexdigest()
+        environ_args = {
+            "method": "GET",
+            "headers": {
+                "If-None-Match": md5_hash,
+            },
+        }
+        storage = storage = GridFS(self.mongo.db)
+        with storage.new_file(filename="myfile.txt") as grid_file:
+            grid_file.write(self.myfile.getvalue())
+            with warnings.catch_warnings():
+                warnings.simplefilter("ignore")
+                grid_file.set("md5", md5_hash)
+
+        with self.app.test_request_context(**environ_args):
+            resp = self.mongo.send_file("myfile.txt")
+            assert resp.status_code == 304
+
     def test_it_sets_cache_headers(self):
         resp = self.mongo.send_file("myfile.txt", cache_for=60)
         assert resp.cache_control.max_age == 60
diff --git a/tests/util.py b/tests/util.py
index 9f2ab83..892b5f3 100644
--- a/tests/util.py
+++ b/tests/util.py
@@ -33,5 +33,5 @@ def setUp(self):
     def tearDown(self):
         assert self.mongo.cx is not None
         self.mongo.cx.drop_database(self.dbname)
-
+        self.mongo.cx.close()
         super().tearDown()