diff --git a/internal/endtoend/testdata/ddl_create_table_like/issue.md b/internal/endtoend/testdata/ddl_create_table_like/issue.md
new file mode 100644
index 0000000000..371a25581d
--- /dev/null
+++ b/internal/endtoend/testdata/ddl_create_table_like/issue.md
@@ -0,0 +1 @@
+https://github.com/sqlc-dev/sqlc/issues/481
diff --git a/internal/endtoend/testdata/ddl_create_table_like/postgresql/pgx/go/db.go b/internal/endtoend/testdata/ddl_create_table_like/postgresql/pgx/go/db.go
new file mode 100644
index 0000000000..2568532b61
--- /dev/null
+++ b/internal/endtoend/testdata/ddl_create_table_like/postgresql/pgx/go/db.go
@@ -0,0 +1,32 @@
+// Code generated by sqlc. DO NOT EDIT.
+// versions:
+//   sqlc v1.23.0
+
+package querytest
+
+import (
+	"context"
+
+	"github.com/jackc/pgx/v5"
+	"github.com/jackc/pgx/v5/pgconn"
+)
+
+type DBTX interface {
+	Exec(context.Context, string, ...interface{}) (pgconn.CommandTag, error)
+	Query(context.Context, string, ...interface{}) (pgx.Rows, error)
+	QueryRow(context.Context, string, ...interface{}) pgx.Row
+}
+
+func New(db DBTX) *Queries {
+	return &Queries{db: db}
+}
+
+type Queries struct {
+	db DBTX
+}
+
+func (q *Queries) WithTx(tx pgx.Tx) *Queries {
+	return &Queries{
+		db: tx,
+	}
+}
diff --git a/internal/endtoend/testdata/ddl_create_table_like/postgresql/pgx/go/models.go b/internal/endtoend/testdata/ddl_create_table_like/postgresql/pgx/go/models.go
new file mode 100644
index 0000000000..e39313798e
--- /dev/null
+++ b/internal/endtoend/testdata/ddl_create_table_like/postgresql/pgx/go/models.go
@@ -0,0 +1,17 @@
+// Code generated by sqlc. DO NOT EDIT.
+// versions:
+//   sqlc v1.23.0
+
+package querytest
+
+import ()
+
+type Change struct {
+	Ranked int32
+}
+
+type ChangesRanked struct {
+	Ranked                 int32
+	RankByEffectSize       int32
+	RankByAbsPercentChange int32
+}
diff --git a/internal/endtoend/testdata/ddl_create_table_like/postgresql/pgx/go/query.sql.go b/internal/endtoend/testdata/ddl_create_table_like/postgresql/pgx/go/query.sql.go
new file mode 100644
index 0000000000..4e5f0215dd
--- /dev/null
+++ b/internal/endtoend/testdata/ddl_create_table_like/postgresql/pgx/go/query.sql.go
@@ -0,0 +1,34 @@
+// Code generated by sqlc. DO NOT EDIT.
+// versions:
+//   sqlc v1.23.0
+// source: query.sql
+
+package querytest
+
+import (
+	"context"
+)
+
+const allRanked = `-- name: AllRanked :many
+SELECT ranked, rank_by_effect_size, rank_by_abs_percent_change FROM changes_ranked
+`
+
+func (q *Queries) AllRanked(ctx context.Context) ([]ChangesRanked, error) {
+	rows, err := q.db.Query(ctx, allRanked)
+	if err != nil {
+		return nil, err
+	}
+	defer rows.Close()
+	var items []ChangesRanked
+	for rows.Next() {
+		var i ChangesRanked
+		if err := rows.Scan(&i.Ranked, &i.RankByEffectSize, &i.RankByAbsPercentChange); err != nil {
+			return nil, err
+		}
+		items = append(items, i)
+	}
+	if err := rows.Err(); err != nil {
+		return nil, err
+	}
+	return items, nil
+}
diff --git a/internal/endtoend/testdata/ddl_create_table_like/postgresql/pgx/query.sql b/internal/endtoend/testdata/ddl_create_table_like/postgresql/pgx/query.sql
new file mode 100644
index 0000000000..759ef862de
--- /dev/null
+++ b/internal/endtoend/testdata/ddl_create_table_like/postgresql/pgx/query.sql
@@ -0,0 +1,2 @@
+-- name: AllRanked :many
+SELECT * FROM changes_ranked;
diff --git a/internal/endtoend/testdata/ddl_create_table_like/postgresql/pgx/schema.sql b/internal/endtoend/testdata/ddl_create_table_like/postgresql/pgx/schema.sql
new file mode 100644
index 0000000000..7365737bab
--- /dev/null
+++ b/internal/endtoend/testdata/ddl_create_table_like/postgresql/pgx/schema.sql
@@ -0,0 +1,9 @@
+CREATE TABLE changes (
+    ranked INT NOT NULL
+);
+
+CREATE TABLE changes_ranked (
+    LIKE changes INCLUDING ALL,
+    rank_by_effect_size INT NOT NULL,
+    rank_by_abs_percent_change INT NOT NULL
+);
diff --git a/internal/endtoend/testdata/ddl_create_table_like/postgresql/pgx/sqlc.yaml b/internal/endtoend/testdata/ddl_create_table_like/postgresql/pgx/sqlc.yaml
new file mode 100644
index 0000000000..5dc63e3f91
--- /dev/null
+++ b/internal/endtoend/testdata/ddl_create_table_like/postgresql/pgx/sqlc.yaml
@@ -0,0 +1,10 @@
+version: "2"
+sql:
+  - engine: "postgresql"
+    schema: "schema.sql"
+    queries: "query.sql"
+    gen:
+      go:
+        package: "querytest"
+        out: "go"
+        sql_package: "pgx/v5"
diff --git a/internal/sql/catalog/table.go b/internal/sql/catalog/table.go
index bfa2da027e..dc30acfa1e 100644
--- a/internal/sql/catalog/table.go
+++ b/internal/sql/catalog/table.go
@@ -289,10 +289,6 @@ func (c *Catalog) createTable(stmt *ast.CreateTableStmt) error {
 		}
 	}
 
-	if stmt.ReferTable != nil && len(stmt.Cols) != 0 {
-		return errors.New("create table node cannot have both a ReferTable and Cols")
-	}
-
 	if stmt.ReferTable != nil {
 		_, original, err := c.getTable(stmt.ReferTable)
 		if err != nil {
@@ -302,23 +298,23 @@ func (c *Catalog) createTable(stmt *ast.CreateTableStmt) error {
 			newCol := *col // make a copy, so changes to the ReferTable don't propagate
 			tbl.Columns = append(tbl.Columns, &newCol)
 		}
-	} else {
-		for _, col := range stmt.Cols {
-			if notNull, ok := seen[col.Colname]; ok {
-				seen[col.Colname] = notNull || col.IsNotNull
-				if a, ok := coltype[col.Colname]; ok {
-					if !sameType(&a, col.TypeName) {
-						return fmt.Errorf("column %q has a type conflict", col.Colname)
-					}
+	}
+
+	for _, col := range stmt.Cols {
+		if notNull, ok := seen[col.Colname]; ok {
+			seen[col.Colname] = notNull || col.IsNotNull
+			if a, ok := coltype[col.Colname]; ok {
+				if !sameType(&a, col.TypeName) {
+					return fmt.Errorf("column %q has a type conflict", col.Colname)
 				}
-				continue
 			}
-			tc, err := c.defineColumn(stmt.Name, col)
-			if err != nil {
-				return err
-			}
-			tbl.Columns = append(tbl.Columns, tc)
+			continue
+		}
+		tc, err := c.defineColumn(stmt.Name, col)
+		if err != nil {
+			return err
 		}
+		tbl.Columns = append(tbl.Columns, tc)
 	}
 
 	// If one of the merged columns was not null, mark the column as not null