This research explores how the expressed health needs of indigenouspeoples with intellectual disabilities (ID) resonate with the mandate of Article 25‘Health' of the United Nations Convention on the Rights of Persons withDisabilities (CRPD). Method: A qualitative approach was used to study perceptions of indigenous peoples with ID about access and expectationsregarding their health care. Their views were triangulated with those of health-workers, senior bureaucrats and United Nations delegates. A exploratory case study methodology was implemented comparing the three jurisdictions of Australia, Mexico and New Zealand. Results: Poverty, discrimination anddisenfranchisement emerged as major determinants of the ill-health experiencedby indigenous peoples with ID. The reach of CRPD Article 25 on indigenoushealth was highly limited within the three case studies, primarily due to the lackof input of indigenous peoples on CRPD development, implementation andmonitoring mechanisms both domestically and internationally. Conclusion: Theoutcomes of the study outline the need to build capacity and rights literacyacross indigenous peoples with ID, while strengthening indigenous leadershipand culturally driven approaches to health.