We report the detection of 376.05 Hz (2.66 ms) coherent X-ray pulsations in NICER observations of a transient outburst of the low-mass X-ray binary IGR J17494−3030 in 2020 October/November. The system is an accreting millisecond X-ray pulsar in a 75-minute ultracompact binary. The mass donor is most likely a ≃0.02 Mꙩ finite-entropy white dwarf composed of He or C/O. The fractional rms pulsed amplitude is 7.4%, and the soft (1–3 keV) X-ray pulse profile contains a significant second harmonic. The pulsed amplitude and pulse phase lag (relative to our mean timing model) are energy dependent, each having a local maximum at 4 and 1.5 keV, respectively. We also recovered the X-ray pulsations in archival 2012 XMM-Newton observations, allowing us to measure a long-term pulsar spin-down rate of ύ= -2.1(7) x (10)^(-14) Hz/s and to infer a pulsar surface dipole magnetic field strength of ≃10^(9)G. We show that the mass transfer in the binary is likely nonconservative, and we discuss various scenarios for mass loss from the system.