In this article, we discuss findings from a study on indigenous youth’s perspectives on and engagement in health care. We carried out an Internet environmental scan, focus groups, and key informant interviews with urban indigenous youth leaders and front-line indigenous practitioners. We found that youth and practitioners regard the formal health care system as ineffective and disrespectful of youth and culture. Indigenous youth espouse a broader approach to health that considers the linkages between culture, identity, and health. Youth are engaged in a variety of health-related activities, from engagement in design of health services and programs to youth empowerment initiatives. The results highlight the value and implications of affirming indigenous youth’s role as determiners of their own health.