diff --git a/docs/installation.rst b/docs/installation.rst
index cb17ebf..d6f5145 100644
--- a/docs/installation.rst
+++ b/docs/installation.rst
@@ -39,6 +39,26 @@ Using pipx
 
     pipx install sqlite-utils
 
+.. _installation_sqlite3_alternatives:
+
+Alternatives to sqlite3
+=======================
+
+By default, ``sqlite-utils`` uses the ``sqlite3`` package bundled with the Python standard library.
+
+Depending on your operating system, this may come with some limitations.
+
+On some platforms the ability to load additional extensions (via ``conn.load_extension(...)`` or ``--load-extension=/path/to/extension``) may be disabled.
+
+You may also see the error ``sqlite3.OperationalError: table sqlite_master may not be modified`` when trying to alter an existing table.
+
+You can work around these limitations by installing either the `pysqlite3 <https://pypi.org/project/pysqlite3/>`__ package or the `sqlean.py <https://pypi.org/project/sqlean.py/>`__ package, both of which provide drop-in replacements for the standard library ``sqlite3`` module but with a recent version of SQLite and full support for loading extensions.
+
+To install ``sqlean.py`` (which has compiled binary wheels available for all major platforms) run the following:
+
+.. code-block:: bash
+
+    sqlite-utils install sqlean.py
 
 .. _installation_completion: