Abstract: This is the third report against the Aboriginal and Torres Strait Islander Health Performance Framework (HPF). The first report, published in 2006, was developed under the auspice of the Australian Health Ministers’ Advisory Council to provide the basis for measuring the impact of the National Strategic Framework for Aboriginal and Torres Strait Islander Health (NSFATSIH). The HPF is designed to inform policy analysis, planning and program information to support the goal of the NSFATSIH which is to ensure ‘that Aboriginal and Torres Strait Islander peoples enjoy a healthy life equal to that of the general population that is enriched by a strong living culture, dignity and justice.’ Results from this report can be used to review current commitments and guide further comprehensive and coordinated effort to close the gap in Indigenous disadvantage. The HPF monitors progress in closing the gap in Indigenous health outcomes, health system performance and broader determinants of health. Health systems comprise all the organisations, resources and activities whose primary purpose is to improve health. Governments, through their stewardship role in policy, planning and program delivery, have a key role to play in defining vision and direction as well as exerting influence and measuring performance. The HPF comprises three tiers: Tier 1—Health status and outcomes Measures of prevalence of disease or injury, human function, life expectancy and wellbeing. How healthy are people? Is it the same for everyone? What are the opportunities for improvement? Tier 2—Determinants of health Measures of the determinants of health including socioeconomic status, environmental factors and health behaviours. Are the factors that determine good health changing? Is it the same for everyone? Where and for whom are these factors changing? Tier 3—Health system performance Measures of the health system including effectiveness, responsiveness, accessibility and sustainability, and how they are changing over time.