diff --git a/src/components/Form/NumberField/NumberField.spec.tsx b/src/components/Form/NumberField/NumberField.spec.tsx
new file mode 100644
index 0000000..0edc8b4
--- /dev/null
+++ b/src/components/Form/NumberField/NumberField.spec.tsx
@@ -0,0 +1,56 @@
+import { useState } from 'react';
+
+import { render, screen } from '@testing-library/react';
+import { describe, expect, it } from 'vitest';
+
+import { NumberField } from './NumberField.tsx';
+
+const TestNumberFieldRadio = ({ options }: { options: { [key: number]: string } }) => {
+  const [error, setError] = useState<string[] | undefined>();
+  const [value, setValue] = useState<number | undefined>();
+  return (
+    <NumberField
+      error={error}
+      kind="number"
+      label="number-field"
+      name="number-field"
+      options={options}
+      setError={setError}
+      setValue={setValue}
+      value={value}
+      variant="radio"
+    />
+  );
+};
+
+const TWO_OPTIONS = { 0: 'The first in the morning', 1: 'Any other' };
+const THREE_OPTIONS = { 1: 'Never', 2: 'Sometimes', 3: 'Always' };
+const FIVE_OPTIONS = { 1: 'Very Low', 2: 'Low', 3: 'Medium', 4: 'High', 5: 'Very High' };
+
+describe('NumberField', () => {
+  describe('radio variant', () => {
+    it('should render one radio per option', () => {
+      render(<TestNumberFieldRadio options={FIVE_OPTIONS} />);
+      expect(screen.getByRole('radiogroup')).toBeInTheDocument();
+      expect(screen.getAllByRole('radio')).toHaveLength(5);
+    });
+    it('should stack two options vertically', () => {
+      render(<TestNumberFieldRadio options={TWO_OPTIONS} />);
+      const radioGroup = screen.getByTestId('radio-group');
+      expect(radioGroup).not.toHaveClass('justify-between');
+      expect(radioGroup.style.gridTemplateColumns).toBe('');
+    });
+    it('should stack three options vertically', () => {
+      render(<TestNumberFieldRadio options={THREE_OPTIONS} />);
+      const radioGroup = screen.getByTestId('radio-group');
+      expect(radioGroup).not.toHaveClass('justify-between');
+      expect(radioGroup.style.gridTemplateColumns).toBe('');
+    });
+    it('should spread four or more options horizontally', () => {
+      render(<TestNumberFieldRadio options={FIVE_OPTIONS} />);
+      const radioGroup = screen.getByTestId('radio-group');
+      expect(radioGroup).toHaveClass('justify-between');
+      expect(radioGroup.style.gridTemplateColumns).toBe('repeat(5, auto)');
+    });
+  });
+});
diff --git a/src/components/Form/NumberField/NumberField.stories.tsx b/src/components/Form/NumberField/NumberField.stories.tsx
index 4374a77..8513d0a 100644
--- a/src/components/Form/NumberField/NumberField.stories.tsx
+++ b/src/components/Form/NumberField/NumberField.stories.tsx
@@ -75,6 +75,55 @@ export const Radio: Story = {
   ]
 };
 
+export const RadioTwoOptions: Story = {
+  decorators: [
+    (Story) => {
+      const [value, setValue] = useState<number | undefined>();
+      return (
+        <Story
+          args={{
+            description: 'Lorem ipsum dolor sit amet consectetur adipisicing elit.',
+            label: 'Two Option Radio Field',
+            name: 'number-radio-two-options',
+            options: {
+              0: 'The first in the morning',
+              1: 'Any other'
+            },
+            setValue,
+            value,
+            variant: 'radio'
+          }}
+        />
+      );
+    }
+  ]
+};
+
+export const RadioThreeOptions: Story = {
+  decorators: [
+    (Story) => {
+      const [value, setValue] = useState<number | undefined>();
+      return (
+        <Story
+          args={{
+            description: 'Lorem ipsum dolor sit amet consectetur adipisicing elit.',
+            label: 'Three Option Radio Field',
+            name: 'number-radio-three-options',
+            options: {
+              1: 'Never',
+              2: 'Sometimes',
+              3: 'Always'
+            },
+            setValue,
+            value,
+            variant: 'radio'
+          }}
+        />
+      );
+    }
+  ]
+};
+
 export const Select: Story = {
   decorators: [
     (Story) => {
diff --git a/src/components/Form/NumberField/NumberFieldRadio.tsx b/src/components/Form/NumberField/NumberFieldRadio.tsx
index ddba5dc..fa48eec 100644
--- a/src/components/Form/NumberField/NumberFieldRadio.tsx
+++ b/src/components/Form/NumberField/NumberFieldRadio.tsx
@@ -4,11 +4,20 @@ import type { NumberFormField } from '@douglasneuroinformatics/libui-form-types'
 import type { Simplify } from 'type-fest';
 
 import { Label, RadioGroup } from '#components';
+import { cn } from '#utils';
 
 import { FieldGroup } from '../FieldGroup/FieldGroup.tsx';
 
 import type { BaseFieldComponentProps } from '../types.ts';
 
+/**
+ * The minimum number of options required to render the group horizontally. Below this, options are
+ * stacked vertically, matching the other radio field variants, since spreading two or three options
+ * across the full width of a wide container pushes them far apart and makes the later options easy
+ * to miss.
+ */
+const MIN_OPTIONS_FOR_HORIZONTAL_LAYOUT = 4;
+
 export type NumberFieldRadioProps = Simplify<
   BaseFieldComponentProps<number> & Extract<NumberFormField, { options: object }>
 >;
@@ -26,23 +35,26 @@ export const NumberFieldRadio = ({
   value
 }: NumberFieldRadioProps) => {
   const radioGroupRef = useRef<HTMLDivElement>(null);
-  const [isColumnLayout, setIsColumnLayout] = useState<boolean>(false);
+  const [isOverflowing, setIsOverflowing] = useState<boolean>(false);
 
   const optionsCount = Object.keys(options).length;
+  const canUseHorizontalLayout = optionsCount >= MIN_OPTIONS_FOR_HORIZONTAL_LAYOUT;
+  const isColumnLayout = !canUseHorizontalLayout || isOverflowing;
 
   useEffect(() => {
+    if (!canUseHorizontalLayout || !radioGroupRef.current) {
+      return;
+    }
     const observer = new ResizeObserver(([entry]) => {
       const { width: rootWidth } = entry!.target.getBoundingClientRect();
       const children = Array.from(entry!.target.children);
       const totalChildWidth = children.reduce((sum, child) => sum + child.scrollWidth, 0);
-      const isOverflowing = totalChildWidth > rootWidth - children.length * 24; // to additional provide spacing between items
-      setIsColumnLayout(isOverflowing);
+      // subtract an allowance so that items always have some spacing between them
+      setIsOverflowing(totalChildWidth > rootWidth - children.length * 24);
     });
-    if (radioGroupRef.current) {
-      observer.observe(radioGroupRef.current);
-    }
+    observer.observe(radioGroupRef.current);
     return () => observer.disconnect();
-  }, []);
+  }, [canUseHorizontalLayout]);
 
   return (
     <FieldGroup name={name}>
@@ -51,12 +63,10 @@ export const NumberFieldRadio = ({
         <FieldGroup.Description description={description} />
       </FieldGroup.Row>
       <RadioGroup
-        className="grid justify-between"
+        className={cn('grid', !isColumnLayout && 'justify-between')}
         name={name}
         ref={radioGroupRef}
-        style={{
-          gridTemplateColumns: isColumnLayout ? 'repeat(1, 1fr)' : `repeat(${optionsCount}, auto)`
-        }}
+        style={isColumnLayout ? undefined : { gridTemplateColumns: `repeat(${optionsCount}, auto)` }}
         value={value?.toString() ?? ''}
         onValueChange={(value) => setValue(parseInt(value, 10))}
       >
diff --git a/src/components/RadioGroup/RadioGroupItem.tsx b/src/components/RadioGroup/RadioGroupItem.tsx
index e2285a0..86691a5 100644
--- a/src/components/RadioGroup/RadioGroupItem.tsx
+++ b/src/components/RadioGroup/RadioGroupItem.tsx
@@ -7,7 +7,7 @@ export const RadioGroupItem: React.FC<React.ComponentProps<typeof Item>> = ({ cl
   return (
     <Item
       className={cn(
-        'border-primary text-primary focus-visible:ring-ring flex aspect-square h-4 w-4 items-center justify-center rounded-full border shadow-sm focus:outline-hidden focus-visible:ring-1 disabled:cursor-not-allowed disabled:opacity-50',
+        'border-primary text-primary focus-visible:ring-ring flex aspect-square h-4 w-4 shrink-0 items-center justify-center rounded-full border shadow-sm focus:outline-hidden focus-visible:ring-1 disabled:cursor-not-allowed disabled:opacity-50',
         className
       )}
       {...props}