diff --git a/homeassistant/components/camera/__init__.py b/homeassistant/components/camera/__init__.py
index bff0a07a9be..31dede33e7a 100644
--- a/homeassistant/components/camera/__init__.py
+++ b/homeassistant/components/camera/__init__.py
@@ -454,7 +454,7 @@ class Camera(Entity):
     def __init__(self) -> None:
         """Initialize a camera."""
         self.stream: Stream | None = None
-        self.stream_options: dict[str, str] = {}
+        self.stream_options: dict[str, str | bool] = {}
         self.content_type: str = DEFAULT_CONTENT_TYPE
         self.access_tokens: collections.deque = collections.deque([], 2)
         self._warned_old_signature = False
diff --git a/homeassistant/components/generic/config_flow.py b/homeassistant/components/generic/config_flow.py
index 435fdf6f729..651ed87da39 100644
--- a/homeassistant/components/generic/config_flow.py
+++ b/homeassistant/components/generic/config_flow.py
@@ -21,6 +21,7 @@ from homeassistant.components.stream import (
     CONF_USE_WALLCLOCK_AS_TIMESTAMPS,
     RTSP_TRANSPORTS,
     SOURCE_TIMEOUT,
+    convert_stream_options,
 )
 from homeassistant.config_entries import ConfigEntry, ConfigFlow, OptionsFlow
 from homeassistant.const import (
@@ -202,21 +203,23 @@ async def async_test_stream(hass, info) -> dict[str, str]:
         # homeassistant.components.stream.__init__.py:create_stream()
         # It may be possible & better to call create_stream() directly.
         stream_options: dict[str, bool | str] = {}
-        if isinstance(stream_source, str) and stream_source[:7] == "rtsp://":
-            stream_options = {
-                "rtsp_flags": "prefer_tcp",
-                "stimeout": "5000000",
-            }
         if rtsp_transport := info.get(CONF_RTSP_TRANSPORT):
             stream_options[CONF_RTSP_TRANSPORT] = rtsp_transport
         if info.get(CONF_USE_WALLCLOCK_AS_TIMESTAMPS):
             stream_options[CONF_USE_WALLCLOCK_AS_TIMESTAMPS] = True
+        pyav_options = convert_stream_options(stream_options)
+        if isinstance(stream_source, str) and stream_source[:7] == "rtsp://":
+            pyav_options = {
+                "rtsp_flags": "prefer_tcp",
+                "stimeout": "5000000",
+                **pyav_options,
+            }
         _LOGGER.debug("Attempting to open stream %s", stream_source)
         container = await hass.async_add_executor_job(
             partial(
                 av.open,
                 stream_source,
-                options=stream_options,
+                options=pyav_options,
                 timeout=SOURCE_TIMEOUT,
             )
         )
@@ -369,7 +372,10 @@ class GenericOptionsFlowHandler(OptionsFlow):
                     CONF_FRAMERATE: user_input[CONF_FRAMERATE],
                     CONF_VERIFY_SSL: user_input[CONF_VERIFY_SSL],
                     CONF_USE_WALLCLOCK_AS_TIMESTAMPS: user_input.get(
-                        CONF_USE_WALLCLOCK_AS_TIMESTAMPS
+                        CONF_USE_WALLCLOCK_AS_TIMESTAMPS,
+                        self.config_entry.options.get(
+                            CONF_USE_WALLCLOCK_AS_TIMESTAMPS, False
+                        ),
                     ),
                 }
                 return self.async_create_entry(
diff --git a/homeassistant/components/stream/__init__.py b/homeassistant/components/stream/__init__.py
index 95e9afe6c36..895bdaf3201 100644
--- a/homeassistant/components/stream/__init__.py
+++ b/homeassistant/components/stream/__init__.py
@@ -90,7 +90,7 @@ def redact_credentials(data: str) -> str:
 def create_stream(
     hass: HomeAssistant,
     stream_source: str,
-    options: dict[str, Any],
+    options: dict[str, str | bool],
     stream_label: str | None = None,
 ) -> Stream:
     """Create a stream with the specified identfier based on the source url.
@@ -496,7 +496,7 @@ STREAM_OPTIONS_SCHEMA: Final = vol.Schema(
 )
 
 
-def convert_stream_options(stream_options: dict[str, Any]) -> dict[str, str]:
+def convert_stream_options(stream_options: dict[str, str | bool]) -> dict[str, str]:
     """Convert options from stream options into PyAV options."""
     pyav_options: dict[str, str] = {}
     try:
@@ -505,6 +505,7 @@ def convert_stream_options(stream_options: dict[str, Any]) -> dict[str, str]:
         raise HomeAssistantError("Invalid stream options") from exc
 
     if rtsp_transport := stream_options.get(CONF_RTSP_TRANSPORT):
+        assert isinstance(rtsp_transport, str)
         pyav_options["rtsp_transport"] = rtsp_transport
     if stream_options.get(CONF_USE_WALLCLOCK_AS_TIMESTAMPS):
         pyav_options["use_wallclock_as_timestamps"] = "1"