Perovskite-silicon tandem solar cells have made rapid progress in the last decade. Still, they suffer from multiple loss channels, one of them being optical losses including reflection and thermalization. In this study, the effect of structures at the air-perovskite and perovskite-silicon interface of the tandem solar cell stack on these two loss channels are evaluated. Regarding reflectance, every structure evaluated led to a reduction relative to the optimized planar stack. The best combination of structures evaluated reduced the reflection loss from 3.1 mA/cm2 (planar reference) to 1.0 mA/cm2 equivalent current. Additionally, nanostructured interfaces can lead to a reduction in thermalization losses by enhancing the absorptance in the perovskite sub-cell close to the bandgap. This means that more current can be generated at a higher voltage under the assumption that current-matching is maintained and the perovskite bandgap is increased accordingly, pathing the way towards higher efficiencies. Here, the largest benefit was obtained using a structure at the upper interface. The best result yielded an increase of 4.9%rel in efficiency. A comparison to a tandem solar cell using a fully textured approach with random pyramids on silicon shows potential benefits for the suggested nanostructured approach regarding thermalization losses, while reflectance is reduced at a similar level. In addition, the applicability of the concept in the module context is shown.