diff --git a/src/mcp/server/mcpserver/utilities/func_metadata.py b/src/mcp/server/mcpserver/utilities/func_metadata.py
@@ -203,7 +203,15 @@ def convert_result(self, result: Any) -> CallToolResult | InputRequiredResult:
         output_model = self.output_model if self.output_schema is not None else None
         if isinstance(result, CallToolResult):
             if output_model is not None and not result.is_error:
-                self._output_adapter(output_model).validate_python(result.structured_content)
+                # Match the plain-return path: accept Python or alias keys, then emit
+                # wire keys (aliases) so structuredContent agrees with outputSchema.
+                adapter = self._output_adapter(output_model)
+                validated = adapter.validate_python(result.structured_content, by_alias=True, by_name=True)
+                if isinstance(validated, BaseModel):
+                    structured_content = validated.model_dump(mode="json", by_alias=True)
+                else:
+                    structured_content = adapter.dump_python(validated, mode="json", by_alias=True)
+                return result.model_copy(update={"structured_content": structured_content})
             return result
 
         unstructured_content = _convert_to_content(result)

diff --git a/tests/server/mcpserver/test_func_metadata.py b/tests/server/mcpserver/test_func_metadata.py
@@ -11,7 +11,7 @@
 import pytest
 from dirty_equals import IsPartialDict
 from mcp_types import CallToolResult, ContentBlock, EmbeddedResource, InputRequiredResult, TextContent
-from pydantic import BaseModel, Field, ValidationError
+from pydantic import BaseModel, ConfigDict, Field, ValidationError
 from typing_extensions import NotRequired, ReadOnly, Required
 
 from mcp import MCPDeprecationWarning
@@ -1322,6 +1322,34 @@ def func_with_aliases() -> ModelWithAliases:  # pragma: no cover
     assert structured_content_defaults["second"] is None
 
 
+def test_call_tool_result_structured_content_alias_normalized():
+    """CallToolResult.structured_content must be alias-normalized like plain returns."""
+
+    class ModelWithAliases(BaseModel):
+        model_config = ConfigDict(populate_by_name=True)
+        field_first: str | None = Field(default=None, alias="first")
+        field_second: str | None = Field(default=None, alias="second")
+
+    def via_call_tool_result() -> Annotated[CallToolResult, ModelWithAliases]:
+        return CallToolResult(
+            content=[],
+            structured_content={"field_first": "hello", "field_second": "world"},
+        )
+
+    meta = func_metadata(via_call_tool_result)
+    assert meta.output_schema is not None
+    assert "first" in meta.output_schema["properties"]
+    assert "field_first" not in meta.output_schema["properties"]
+
+    converted = meta.convert_result(via_call_tool_result())
+    assert isinstance(converted, CallToolResult)
+    structured_content = converted.structured_content
+    assert structured_content is not None
+    assert structured_content == {"first": "hello", "second": "world"}
+    assert "field_first" not in structured_content
+    assert "field_second" not in structured_content
+
+
 def test_basemodel_reserved_names():
     """Test that functions with parameters named after BaseModel methods work correctly"""