diff --git a/CMakeLists.txt b/CMakeLists.txt
index b10635e..a3c1388 100644
--- a/CMakeLists.txt
+++ b/CMakeLists.txt
@@ -295,7 +295,7 @@ if(NOT SNMALLOC_HEADER_ONLY_LIBRARY)
       if (NOT ${SNMALLOC_CLEANUP} STREQUAL CXX11_DESTRUCTORS)
         check_linker_flag(CXX "-nostdlib++" SNMALLOC_LINKER_SUPPORT_NOSTDLIBXX)
         if (SNMALLOC_LINKER_SUPPORT_NOSTDLIBXX)
-          target_link_options(${name} PRIVATE -nostdlib++)
+         target_link_options(${name} PRIVATE -nostdlib++)
         else()
           set_target_properties(${name} PROPERTIES LINKER_LANGUAGE C)
         endif()
diff --git a/src/ds/flaglock.h b/src/ds/flaglock.h
index 9b2458d..69ec307 100644
--- a/src/ds/flaglock.h
+++ b/src/ds/flaglock.h
@@ -2,6 +2,8 @@
 
 #include "bits.h"
 
+#include <atomic>
+
 namespace snmalloc
 {
   class FlagLock
diff --git a/src/ds/helpers.h b/src/ds/helpers.h
index f8ad92c..b8bc15b 100644
--- a/src/ds/helpers.h
+++ b/src/ds/helpers.h
@@ -4,6 +4,7 @@
 #include "flaglock.h"
 
 #include <array>
+#include <atomic>
 #include <type_traits>
 
 namespace snmalloc
diff --git a/src/mem/corealloc.h b/src/mem/corealloc.h
index 212d14f..ed97a6b 100644
--- a/src/mem/corealloc.h
+++ b/src/mem/corealloc.h
@@ -8,6 +8,7 @@
 #include "pool.h"
 #include "remotecache.h"
 #include "sizeclasstable.h"
+#include "ticker.h"
 
 namespace snmalloc
 {
@@ -96,6 +97,11 @@ namespace snmalloc
      */
     LocalCache* attached_cache;
 
+    /**
+     * Ticker to query the clock regularly at a lower cost.
+     */
+    Ticker<typename SharedStateHandle::Pal> ticker;
+
     /**
      * The message queue needs to be accessible from other threads
      *
@@ -405,6 +411,7 @@ namespace snmalloc
         std::cout << "Slab is woken up" << std::endl;
 #endif
 
+        ticker.check_tick();
         return;
       }
 
@@ -419,6 +426,7 @@ namespace snmalloc
       {
         dealloc_local_slabs(sizeclass);
       }
+      ticker.check_tick();
     }
 
     /**
@@ -698,7 +706,8 @@ namespace snmalloc
           sl.insert(meta);
         }
 
-        return finish_alloc<zero_mem, SharedStateHandle>(p, sizeclass);
+        auto r = finish_alloc<zero_mem, SharedStateHandle>(p, sizeclass);
+        return ticker.check_tick(r);
       }
       return small_alloc_slow<zero_mem>(sizeclass, fast_free_list, rsize);
     }
@@ -766,7 +775,8 @@ namespace snmalloc
         alloc_classes[sizeclass].available.insert(meta);
       }
 
-      return finish_alloc<zero_mem, SharedStateHandle>(p, sizeclass);
+      auto r = finish_alloc<zero_mem, SharedStateHandle>(p, sizeclass);
+      return ticker.check_tick(r);
     }
 
     /**
diff --git a/src/mem/ticker.h b/src/mem/ticker.h
new file mode 100644
index 0000000..af397c6
--- /dev/null
+++ b/src/mem/ticker.h
@@ -0,0 +1,97 @@
+#pragma once
+
+#include "../ds/defines.h"
+
+#include <cstdint>
+
+namespace snmalloc
+{
+  /**
+   * This class will attempt to call the PAL every 50ms to check the time.
+   * If the caller of check_tick, does so more frequently, it will attempt
+   * to back-off to only query the time, every n calls to check_tick, where
+   * `n` adapts to the current frequency of calling.
+   *
+   * The aim is to reduce the time spent querying the time as this might be
+   * an expensive operation if time has been virtualised.
+   */
+  template<typename PAL>
+  class Ticker
+  {
+    /**
+     * Calls to check_tick required before the time is next queried
+     */
+    uint64_t count_down = 1;
+
+    /**
+     * Number of ticks next time we check the time.
+     * That is,
+     *    counted - count_down
+     * Is how many ticks, since last_epoch_ms was updated.
+     */
+    uint64_t counted = 1;
+
+    /**
+     * Last time we queried the clock.
+     */
+    uint64_t last_query_ms = 0;
+
+    /**
+     * Slow path that actually queries clock and sets up
+     * how many calls for the next time we hit the slow path.
+     */
+    template<typename T = void*>
+    SNMALLOC_SLOW_PATH T check_tick_slow(T p = nullptr)
+    {
+      uint64_t now_ms = PAL::time_in_ms();
+
+      // Set up clock.
+      if (last_query_ms == 0)
+      {
+        last_query_ms = now_ms;
+        count_down = 1;
+        counted = 1;
+        return p;
+      }
+
+      uint64_t duration_ms = now_ms - last_query_ms;
+      last_query_ms = now_ms;
+
+      // Check is below clock resolution
+      if (duration_ms == 0)
+      {
+        // Exponential back off
+        count_down = counted;
+        counted *= 2;
+        return p;
+      }
+
+      constexpr size_t deadline_in_ms = 50;
+
+      // Estimate number of ticks to get to the new deadline, based on the
+      // current interval
+      auto new_deadline_in_ticks =
+        ((1 + counted) * deadline_in_ms) / duration_ms;
+
+      counted = new_deadline_in_ticks;
+      count_down = new_deadline_in_ticks;
+
+      return p;
+    }
+
+  public:
+    template<typename T = void*>
+    SNMALLOC_FAST_PATH T check_tick(T p = nullptr)
+    {
+      // Check before decrement, so that later calcations can use
+      // count_down == 0 for check on the next call.
+      // This is used if the ticks are way below the frequency of
+      // heart beat.
+      if (--count_down == 0)
+      {
+        return check_tick_slow(p);
+      }
+      return p;
+    }
+  };
+} // namespace snmalloc
diff --git a/src/pal/pal_concept.h b/src/pal/pal_concept.h
index aff9354..a476cce 100644
--- a/src/pal/pal_concept.h
+++ b/src/pal/pal_concept.h
@@ -3,7 +3,7 @@
 #ifdef __cpp_concepts
 #  include "../ds/concept.h"
 #  include "pal_consts.h"
-
+#  include "pal_ds.h"
 #  include <utility>
 
 namespace snmalloc
diff --git a/src/pal/pal_consts.h b/src/pal/pal_consts.h
index 8497e33..537a7c8 100644
--- a/src/pal/pal_consts.h
+++ b/src/pal/pal_consts.h
@@ -3,6 +3,7 @@
 #include "../ds/defines.h"
 
 #include <atomic>
+#include <functional>
 
 namespace snmalloc
 {
@@ -85,70 +86,7 @@ namespace snmalloc
   /**
    * Default Tag ID for the Apple class
    */
-  static const uint8_t PALAnonDefaultID = 241;
-
-  /**
-   * This struct is used to represent callbacks for notification from the
-   * platform. It contains a next pointer as client is responsible for
-   * allocation as we cannot assume an allocator at this point.
-   */
-  struct PalNotificationObject
-  {
-    std::atomic<PalNotificationObject*> pal_next = nullptr;
-
-    void (*pal_notify)(PalNotificationObject* self);
-
-    PalNotificationObject(void (*pal_notify)(PalNotificationObject* self))
-    : pal_notify(pal_notify)
-    {}
-  };
-
-  /***
-   * Wrapper for managing notifications for PAL events
-   */
-  class PalNotifier
-  {
-    /**
-     * List of callbacks to notify
-     */
-    std::atomic<PalNotificationObject*> callbacks{nullptr};
-
-  public:
-    /**
-     * Register a callback object to be notified
-     *
-     * The object should never be deallocated by the client after calling
-     * this.
-     */
-    void register_notification(PalNotificationObject* callback)
-    {
-      callback->pal_next = nullptr;
-
-      auto prev = &callbacks;
-      auto curr = prev->load();
-      do
-      {
-        while (curr != nullptr)
-        {
-          prev = &(curr->pal_next);
-          curr = prev->load();
-        }
-      } while (!prev->compare_exchange_weak(curr, callback));
-    }
-
-    /**
-     * Calls the pal_notify of all the registered objects.
-     */
-    void notify_all()
-    {
-      PalNotificationObject* curr = callbacks;
-      while (curr != nullptr)
-      {
-        curr->pal_notify(curr);
-        curr = curr->pal_next;
-      }
-    }
-  };
+  static const int PALAnonDefaultID = 241;
 
   /**
    * Query whether the PAL supports a specific feature.
diff --git a/src/pal/pal_ds.h b/src/pal/pal_ds.h
new file mode 100644
index 0000000..852d83c
--- /dev/null
+++ b/src/pal/pal_ds.h
@@ -0,0 +1,163 @@
+#pragma once
+
+#include "../ds/defines.h"
+#include "../ds/helpers.h"
+
+#include <atomic>
+#include <functional>
+
+namespace snmalloc
+{
+  template<typename T>
+  class PalList
+  {
+    /**
+     * List of callbacks to notify
+     */
+    std::atomic<T*> elements{nullptr};
+
+    static_assert(
+      std::is_same<decltype(T::pal_next), std::atomic<T*>>::value,
+      "Required pal_next type.");
+
+  public:
+    /**
+     * Add an element to the list
+     */
+    void add(T* element)
+    {
+      auto prev = &elements;
+      auto curr = prev->load();
+      do
+      {
+        while (curr != nullptr)
+        {
+          prev = &(curr->pal_next);
+          curr = prev->load();
+        }
+      } while (!prev->compare_exchange_weak(curr, element));
+    }
+
+    /**
+     * Applies function to all the elements of the list
+     */
+    void apply_all(function_ref<void(T*)> func)
+    {
+      T* curr = elements;
+      while (curr != nullptr)
+      {
+        func(curr);
+        curr = curr->pal_next;
+      }
+    }
+  };
+
+  /**
+   * This struct is used to represent callbacks for notification from the
+   * platform. It contains a next pointer as client is responsible for
+   * allocation as we cannot assume an allocator at this point.
+   */
+  struct PalNotificationObject
+  {
+    std::atomic<PalNotificationObject*> pal_next = nullptr;
+
+    void (*pal_notify)(PalNotificationObject* self);
+
+    PalNotificationObject(void (*pal_notify)(PalNotificationObject* self))
+    : pal_notify(pal_notify)
+    {}
+  };
+
+  /***
+   * Wrapper for managing notifications for PAL events
+   */
+  class PalNotifier
+  {
+    /**
+     * List of callbacks to notify
+     */
+    PalList<PalNotificationObject> callbacks;
+
+  public:
+    /**
+     * Register a callback object to be notified
+     *
+     * The object should never be deallocated by the client after calling
+     * this.
+     */
+    void register_notification(PalNotificationObject* callback)
+    {
+      callbacks.add(callback);
+    }
+
+    /**
+     * Calls the pal_notify of all the registered objects.
+     */
+    void notify_all()
+    {
+      callbacks.apply_all([](auto curr) { curr->pal_notify(curr); });
+    }
+  };
+
+  class PalTimerObject
+  {
+    friend class PalTimer;
+    template<typename T>
+    friend class PalList;
+
+    std::atomic<PalTimerObject*> pal_next;
+
+    void (*pal_notify)(PalTimerObject* self);
+
+    uint64_t last_run = 0;
+    uint64_t repeat;
+
+  public:
+    PalTimerObject(void (*pal_notify)(PalTimerObject* self), uint64_t repeat)
+    : pal_notify(pal_notify), repeat(repeat)
+    {}
+  };
+
+  /**
+   * Simple mechanism for handling timers.
+   *
+   * Note: This is really designed for a very small number of timers,
+   * and this design should be changed if that is no longer the case.
+   */
+  class PalTimer
+  {
+    /**
+     * List of callbacks to notify
+     */
+    PalList<PalTimerObject> timers;
+
+  public:
+    /**
+     * Register a callback to be called every repeat milliseconds.
+     */
+    void register_timer(PalTimerObject* timer)
+    {
+      timers.add(timer);
+    }
+
+    void check(uint64_t time_ms)
+    {
+      static std::atomic_flag lock = ATOMIC_FLAG_INIT;
+
+      // Depulicate calls into here, and make single threaded.
+      if (lock.test_and_set())
+      {
+        timers.apply_all([time_ms](PalTimerObject* curr) {
+          if (
+            (curr->last_run == 0) ||
+            ((time_ms - curr->last_run) > curr->repeat))
+          {
+            curr->last_run = time_ms;
+            curr->pal_notify(curr);
+          }
+        });
+        lock.clear();
+      }
+    }
+  };
+} // namespace snmalloc
diff --git a/src/pal/pal_noalloc.h b/src/pal/pal_noalloc.h
index a98add6..b6882c3 100644
--- a/src/pal/pal_noalloc.h
+++ b/src/pal/pal_noalloc.h
@@ -6,6 +6,7 @@
 #include "../aal/aal.h"
 #include "pal_concept.h"
 #include "pal_consts.h"
+#include "pal_timer_default.h"
 
 #include <cstring>
 
@@ -27,7 +28,7 @@ namespace snmalloc
    * ever use.
    */
   template<SNMALLOC_CONCEPT(PALNoAllocBase) BasePAL>
-  struct PALNoAlloc
+  struct PALNoAlloc : public PalTimerDefaultImpl<BasePAL>
   {
     /**
      * Bitmap of PalFeatures flags indicating the optional features that this
diff --git a/src/pal/pal_plain.h b/src/pal/pal_plain.h
index 9d8c8d9..57bfe18 100644
--- a/src/pal/pal_plain.h
+++ b/src/pal/pal_plain.h
@@ -1,13 +1,14 @@
 #pragma once
 
 #include "../ds/bits.h"
+#include "pal_timer_default.h"
 
 namespace snmalloc
 {
   // Can be extended
   // Will require a reserve method in subclasses.
   template<class State>
-  class PALPlainMixin : public State
+  class PALPlainMixin : public State, public PalTimerDefaultImpl<State>
   {
   public:
     // Notify platform that we will not be using these pages
diff --git a/src/pal/pal_posix.h b/src/pal/pal_posix.h
index 3f3d163..e166bd2 100644
--- a/src/pal/pal_posix.h
+++ b/src/pal/pal_posix.h
@@ -4,6 +4,7 @@
 #  include <iostream>
 #endif
 #include "../ds/address.h"
+#include "pal_timer_default.h"
 #if defined(SNMALLOC_BACKTRACE_HEADER)
 #  include SNMALLOC_BACKTRACE_HEADER
 #endif
@@ -39,7 +40,7 @@ namespace snmalloc
    * version.
    */
   template<class OS>
-  class PALPOSIX
+  class PALPOSIX : public PalTimerDefaultImpl<PALPOSIX<OS>>
   {
     /**
      * Helper class to access the `default_mmap_flags` field of `OS` if one
@@ -348,5 +349,19 @@ namespace snmalloc
       }
       error("Entropy requested on platform that does not provide entropy");
     }
+
+    static uint64_t internal_time_in_ms()
+    {
+      auto hold = KeepErrno();
+
+      struct timespec ts;
+      if (clock_gettime(CLOCK_MONOTONIC, &ts) == -1)
+      {
+        error("Failed to get time");
+      }
+
+      return (static_cast<uint64_t>(ts.tv_sec) * 1000) +
+        (static_cast<uint64_t>(ts.tv_nsec) / 1000000);
+    }
   };
 } // namespace snmalloc
diff --git a/src/pal/pal_timer_default.h b/src/pal/pal_timer_default.h
new file mode 100644
index 0000000..a38094a
--- /dev/null
+++ b/src/pal/pal_timer_default.h
@@ -0,0 +1,32 @@
+
+#pragma once
+
+#include "pal_consts.h"
+#include "pal_ds.h"
+
+#include <chrono>
+
+namespace snmalloc
+{
+  template<typename PalTime>
+  class PalTimerDefaultImpl
+  {
+    inline static PalTimer timers{};
+
+  public:
+    static uint64_t time_in_ms()
+    {
+      auto time = PalTime::internal_time_in_ms();
+
+      // Process timers
+      timers.check(time);
+
+      return time;
+    }
+
+    static void register_timer(PalTimerObject* timer)
+    {
+      timers.register_timer(timer);
+    }
+  };
+}
\ No newline at end of file
diff --git a/src/pal/pal_windows.h b/src/pal/pal_windows.h
index 425810b..b7de864 100644
--- a/src/pal/pal_windows.h
+++ b/src/pal/pal_windows.h
@@ -2,6 +2,7 @@
 
 #include "../ds/address.h"
 #include "../ds/bits.h"
+#include "pal_timer_default.h"
 
 #ifdef _WIN32
 #  ifndef _MSC_VER
@@ -22,9 +23,11 @@
 #    endif
 #  endif
 
+#  include <chrono>
+
 namespace snmalloc
 {
-  class PALWindows
+  class PALWindows : public PalTimerDefaultImpl<PALWindows>
   {
     /**
      * A flag indicating that we have tried to register for low-memory
@@ -206,6 +209,14 @@ namespace snmalloc
         error("Failed to get entropy.");
       return result;
     }
+
+    static uint64_t internal_time_in_ms()
+    {
+      return static_cast<uint64_t>(
+        std::chrono::duration_cast<std::chrono::milliseconds>(
+          std::chrono::steady_clock::now().time_since_epoch())
+          .count());
+    }
   };
 }
 #endif