diff --git a/common/reviews/api/tools.api.md b/common/reviews/api/tools.api.md
index cde8be5d5..c6043e86d 100644
--- a/common/reviews/api/tools.api.md
+++ b/common/reviews/api/tools.api.md
@@ -2893,6 +2893,10 @@ interface IToolGroup {
         (): undefined | string;
     };
     // (undocumented)
+    getDefaultMousePrimary: {
+        (): MouseBindings;
+    };
+    // (undocumented)
     getToolConfiguration: {
         (toolName: string, configurationPath: string): any;
     };
diff --git a/packages/tools/src/eventDispatchers/shared/getActiveToolForKeyboardEvent.ts b/packages/tools/src/eventDispatchers/shared/getActiveToolForKeyboardEvent.ts
index 80d024bb2..1a0f47713 100644
--- a/packages/tools/src/eventDispatchers/shared/getActiveToolForKeyboardEvent.ts
+++ b/packages/tools/src/eventDispatchers/shared/getActiveToolForKeyboardEvent.ts
@@ -36,6 +36,7 @@ export default function getActiveToolForKeyboardEvent(
   }
 
   const toolGroupToolNames = Object.keys(toolGroup.toolOptions);
+  const defaultMousePrimary = toolGroup.getDefaultMousePrimary();
 
   for (let j = 0; j < toolGroupToolNames.length; j++) {
     const toolName = toolGroupToolNames[j];
@@ -47,7 +48,7 @@ export default function getActiveToolForKeyboardEvent(
       toolOptions.bindings.length &&
       toolOptions.bindings.some(
         (binding) =>
-          binding.mouseButton === (mouseButton ?? MouseBindings.Primary) &&
+          binding.mouseButton === (mouseButton ?? defaultMousePrimary) &&
           binding.modifierKey === modifierKey
       );
 
diff --git a/packages/tools/src/eventDispatchers/shared/getActiveToolForMouseEvent.ts b/packages/tools/src/eventDispatchers/shared/getActiveToolForMouseEvent.ts
index 34ee4c63d..89a63c8df 100644
--- a/packages/tools/src/eventDispatchers/shared/getActiveToolForMouseEvent.ts
+++ b/packages/tools/src/eventDispatchers/shared/getActiveToolForMouseEvent.ts
@@ -38,6 +38,7 @@ export default function getActiveToolForMouseEvent(
   }
 
   const toolGroupToolNames = Object.keys(toolGroup.toolOptions);
+  const defaultMousePrimary = toolGroup.getDefaultMousePrimary();
 
   for (let j = 0; j < toolGroupToolNames.length; j++) {
     const toolName = toolGroupToolNames[j];
@@ -50,7 +51,7 @@ export default function getActiveToolForMouseEvent(
       toolOptions.bindings.some((binding) => {
         return (
           binding.mouseButton ===
-            (mouseEvent ? mouseEvent.buttons : MouseBindings.Primary) &&
+            (mouseEvent ? mouseEvent.buttons : defaultMousePrimary) &&
           binding.modifierKey === modifierKey
         );
       });
diff --git a/packages/tools/src/eventDispatchers/shared/getActiveToolForTouchEvent.ts b/packages/tools/src/eventDispatchers/shared/getActiveToolForTouchEvent.ts
index 99b67e095..35d2fbe32 100644
--- a/packages/tools/src/eventDispatchers/shared/getActiveToolForTouchEvent.ts
+++ b/packages/tools/src/eventDispatchers/shared/getActiveToolForTouchEvent.ts
@@ -38,6 +38,7 @@ export default function getActiveToolForTouchEvent(
   // If any keyboard modifier key is also pressed
   const modifierKey =
     getMouseModifier(touchEvent) || keyEventListener.getModifierKey();
+  const defaultMousePrimary = toolGroup.getDefaultMousePrimary();
 
   for (let j = 0; j < toolGroupToolNames.length; j++) {
     const toolName = toolGroupToolNames[j];
@@ -55,7 +56,7 @@ export default function getActiveToolForTouchEvent(
         (binding) =>
           (binding.numTouchPoints === numTouchPoints ||
             (numTouchPoints === 1 &&
-              binding.mouseButton === MouseBindings.Primary)) &&
+              binding.mouseButton === defaultMousePrimary)) &&
           binding.modifierKey === modifierKey
       );
 
diff --git a/packages/tools/src/store/ToolGroupManager/ToolGroup.ts b/packages/tools/src/store/ToolGroupManager/ToolGroup.ts
index 4c6fa125f..aa93fc613 100644
--- a/packages/tools/src/store/ToolGroupManager/ToolGroup.ts
+++ b/packages/tools/src/store/ToolGroupManager/ToolGroup.ts
@@ -406,12 +406,13 @@ export default class ToolGroup implements IToolGroup {
       }
     );
 
+    const defaultMousePrimary = this.getDefaultMousePrimary();
+
     // Remove the primary button bindings without modifiers, if they exist
     toolOptions.bindings = toolOptions.bindings.filter(
       (binding) =>
-        binding.mouseButton !== MouseBindings.Primary || binding.modifierKey
+        binding.mouseButton !== defaultMousePrimary || binding.modifierKey
     );
-
     // If there are other bindings, set the tool to be active
     let mode = Passive;
     if (toolOptions.bindings.length !== 0) {
@@ -620,6 +621,14 @@ export default class ToolGroup implements IToolGroup {
     return true;
   }
 
+  /**
+   * Returns the default mouse primary button.
+   *
+   */
+  public getDefaultMousePrimary(): MouseBindings {
+    return MouseBindings.Primary;
+  }
+
   /**
    * Get the configuration of tool. It returns only the config for the given path (in case exists).
    * ConfigurationPath is the the path of the property to get separated by '.'.
@@ -650,9 +659,11 @@ export default class ToolGroup implements IToolGroup {
    * @returns A boolean value.
    */
   private _hasMousePrimaryButtonBinding(toolOptions) {
+    const defaultMousePrimary = this.getDefaultMousePrimary();
+
     return toolOptions?.bindings?.some(
       (binding) =>
-        binding.mouseButton === MouseBindings.Primary &&
+        binding.mouseButton === defaultMousePrimary &&
         binding.modifierKey === undefined
     );
   }
diff --git a/packages/tools/src/types/IToolGroup.ts b/packages/tools/src/types/IToolGroup.ts
index bde30470e..430b2225d 100644
--- a/packages/tools/src/types/IToolGroup.ts
+++ b/packages/tools/src/types/IToolGroup.ts
@@ -1,6 +1,6 @@
 import type { Types } from '@cornerstonejs/core';
 import { SetToolBindingsType, ToolOptionsType } from './ISetToolModeOptions';
-
+import { MouseBindings } from '../enums';
 /**
  * ToolGroup interface
  */
@@ -69,4 +69,7 @@ export default interface IToolGroup {
   getToolConfiguration: {
     (toolName: string, configurationPath: string): any;
   };
+  getDefaultMousePrimary: {
+    (): MouseBindings;
+  };
 }