diff --git a/myst_parser/mdit_to_docutils/base.py b/myst_parser/mdit_to_docutils/base.py
index a275cd71..6aac6a48 100644
--- a/myst_parser/mdit_to_docutils/base.py
+++ b/myst_parser/mdit_to_docutils/base.py
@@ -504,10 +504,11 @@ def renderInlineAsText(self, tokens: list[SyntaxTreeNode]) -> str:  # noqa: N802
         result = ""
 
         for token in tokens or []:
-            if token.type == "text":
+            if token.type in {"text", "text_special"}:
+                # An escape or entity is a text_special token with no children.
+                # Its content is the character the alt text must keep
+                # (executablebooks/MyST-Parser#1210).
                 result += token.content
-            # elif token.type == "image":
-            #     result += self.renderInlineAsText(token.children)
             else:
                 result += self.renderInlineAsText(token.children or [])
         return result
diff --git a/tests/test_renderers/fixtures/docutil_syntax_elements.md b/tests/test_renderers/fixtures/docutil_syntax_elements.md
index 9b12b60f..2ab785f4 100644
--- a/tests/test_renderers/fixtures/docutil_syntax_elements.md
+++ b/tests/test_renderers/fixtures/docutil_syntax_elements.md
@@ -190,6 +190,44 @@ Image with escapable html:
         <image alt="alt" uri="http://www.google%3C%3E.com">
 .
 
+Image alt with escapes and entities:
+.
+![a \* b &amp; C:\Python26](x.png)
+.
+<document source="notset">
+    <paragraph>
+        <image alt="a * b & C:\Python26" uri="x.png">
+.
+
+Image alt with escapes and entities in emphasis:
+.
+![a *\* b &copy;*](x.png)
+.
+<document source="notset">
+    <paragraph>
+        <image alt="a * b ©" uri="x.png">
+.
+
+Image alt with an escape in a nested image:
+.
+![outer ![in\*ner](y.png)](x.png)
+.
+<document source="notset">
+    <paragraph>
+        <image alt="outer in*ner" uri="x.png">
+.
+
+Image alt with an escape, reference style:
+.
+![a \* b][r]
+
+[r]: x.png
+.
+<document source="notset">
+    <paragraph>
+        <image alt="a * b" uri="x.png">
+.
+
 Block Quote:
 .
 > *foo*