diff --git a/src/insexpand.c b/src/insexpand.c
index bf28bb2c13..2aabacd83a 100644
--- a/src/insexpand.c
+++ b/src/insexpand.c
@@ -7590,40 +7590,52 @@ ins_compl_make_linear(void)
  * cpt_sources_index) from the completion list.
  */
 #ifdef FEAT_COMPL_FUNC
-    static compl_T *
+    static void
 remove_old_matches(void)
 {
-    compl_T *sublist_start = NULL, *sublist_end = NULL, *insert_at = NULL;
-    compl_T *current, *next;
-    int	    compl_shown_removed = FALSE;
+    compl_T *current;
+    int	    shown_match_removed = FALSE;
     int	    forward = (compl_first_match->cp_cpt_source_idx < 0);
 
+    if (cpt_sources_index < 0)
+	return;
+
     compl_direction = forward ? FORWARD : BACKWARD;
     compl_shows_dir = compl_direction;
 
-    // Identify the sublist of old matches that needs removal
-    for (current = compl_first_match; current != NULL; current = current->cp_next)
+    // When 'fuzzy' is enabled, items are not ordered by their original source
+    // order (cpt_sources_index). So, remove items one by one.
+    for (current = compl_first_match; current != NULL; )
     {
-	if (current->cp_cpt_source_idx < cpt_sources_index &&
-		(forward || (!forward && !insert_at)))
-	    insert_at = current;
-
 	if (current->cp_cpt_source_idx == cpt_sources_index)
 	{
-	    if (!sublist_start)
-		sublist_start = current;
-	    sublist_end = current;
-	    if (!compl_shown_removed && compl_shown_match == current)
-		compl_shown_removed = TRUE;
-	}
+	    compl_T *to_delete = current;
 
-	if ((forward && current->cp_cpt_source_idx > cpt_sources_index)
-		|| (!forward && insert_at))
-	    break;
+	    if (!shown_match_removed && compl_shown_match == current)
+		shown_match_removed = TRUE;
+
+	    current = current->cp_next;
+
+	    if (to_delete == compl_first_match)  // node to remove is at head
+	    {
+		compl_first_match = to_delete->cp_next;
+		compl_first_match->cp_prev = NULL;
+	    }
+	    else if (to_delete->cp_next == NULL) // node to remove is at tail
+		to_delete->cp_prev->cp_next = NULL;
+	    else // node is in the moddle
+	    {
+		to_delete->cp_prev->cp_next = to_delete->cp_next;
+		to_delete->cp_next->cp_prev = to_delete->cp_prev;
+	    }
+	    ins_compl_item_free(to_delete);
+	}
+	else
+	    current = current->cp_next;
     }
 
     // Re-assign compl_shown_match if necessary
-    if (compl_shown_removed)
+    if (shown_match_removed)
     {
 	if (forward)
 	    compl_shown_match = compl_first_match;
@@ -7636,27 +7648,19 @@ remove_old_matches(void)
 	}
     }
 
-    if (!sublist_start) // No nodes to remove
-	return insert_at;
-
-    // Update links to remove sublist
-    if (sublist_start->cp_prev)
-	sublist_start->cp_prev->cp_next = sublist_end->cp_next;
-    else
-	compl_first_match = sublist_end->cp_next;
-
-    if (sublist_end->cp_next)
-	sublist_end->cp_next->cp_prev = sublist_start->cp_prev;
-
-    // Free all nodes in the sublist
-    sublist_end->cp_next = NULL;
-    for (current = sublist_start; current != NULL; current = next)
+    // Re-assign compl_curr_match
+    compl_curr_match = compl_first_match;
+    for (current = compl_first_match; current != NULL; )
     {
-	next = current->cp_next;
-	ins_compl_item_free(current);
+	if ((forward ? current->cp_cpt_source_idx < cpt_sources_index
+		    : current->cp_cpt_source_idx > cpt_sources_index))
+	{
+	    compl_curr_match = forward ? current : current->cp_next;
+	    current = current->cp_next;
+	}
+	else
+	    break;
     }
-
-    return insert_at;
 }
 #endif
 
@@ -7716,7 +7720,7 @@ cpt_compl_refresh(void)
 	    cb = get_callback_if_cpt_func(p, cpt_sources_index);
 	    if (cb)
 	    {
-		compl_curr_match = remove_old_matches();
+		remove_old_matches();
 		ret = get_userdefined_compl_info(curwin->w_cursor.col, cb,
 			&startcol);
 		if (ret == FAIL)
diff --git a/src/testdir/test_ins_complete.vim b/src/testdir/test_ins_complete.vim
index ba449f2dbc..48623f26a7 100644
--- a/src/testdir/test_ins_complete.vim
+++ b/src/testdir/test_ins_complete.vim
@@ -5942,4 +5942,33 @@ func Test_fuzzy_select_item_when_acl()
   call StopVimInTerminal(buf)
 endfunc
 
+" Issue #18378: crash when fuzzy reorders items during refresh:always
+func Test_refresh_always_with_fuzzy()
+  func ComplFunc1(findstart, base)
+    if a:findstart
+      return 1
+    else
+      return ['foo', 'foobar']
+    endif
+  endfunc
+  func ComplFunc2(findstart, base)
+    if a:findstart
+      return 1
+    else
+      return #{words: ['foo'], refresh: 'always'}
+    endif
+  endfunc
+  set complete=.,FComplFunc1,FComplFunc2
+  set autocomplete
+  call test_override("char_avail", 1)
+  new
+  call setline(1, ['fox'])
+  exe "normal! Gofo"
+  bw!
+  delfunc ComplFunc1
+  delfunc ComplFunc2
+  set complete& autocomplete&
+  call test_override("char_avail", 0)
+endfunc
+
 " vim: shiftwidth=2 sts=2 expandtab nofoldenable
diff --git a/src/version.c b/src/version.c
index 490b882f9e..5c1424ed32 100644
--- a/src/version.c
+++ b/src/version.c
@@ -729,6 +729,8 @@ static char *(features[]) =
 
 static int included_patches[] =
 {   /* Add new patch number below this line */
+/**/
+    1799,
 /**/
     1798,
 /**/