Around the world, Indigenous peoples face enormous challenges to their health and well-being as a result of climate change. While they live in diverse contexts, they are subject to conditions that disproportionately increase their vulnerability to climate change and barriers to adaptation. These barriers include their unique relationships with the natural environment, socioeconomic deprivation, a greater existing burden of disease, poorer access to resources to respond, poorer quality of health care, as well as social and political marginalisation. Moreover, the rights of Indigenous peoples are threatened by responses to climate change at global, national, and local levels. This article notes that while climate action presents many opportunities to improve health and reduce inequities, climate mitigation and adaptation policies pose a significant risk for inflicting harm on Indigenous peoples by exacerbating inequities and eroding their rights still further. This article examines how Indigenous health is interwoven with climate change and seeks to identify Indigenous health promotion solutions that will ensure equitable responses to climate change. The author adopts a Kaupapa Māori positioning in this analysis of health impacts of climate change, and critiques Western knowledges and structures that undermine Indigenous rights and development. The article explains that the broader context of colonial oppression, marginalisation and dispossession must be examined before we can understand and address climate-related health impacts for Indigenous peoples. It argues that health promotion must engage in a process of decolonisation by deconstructing its own systems and practices to avoid reinforcing colonialism and perpetuating inequities. Health promotion has to support Indigenous selfdetermination and allow Indigenous knowledges to provide solutions for climate change and health.