Abstract: Objectives: To highlight the scope and ramifications of racism on health and health care of Indigenous Australians, and suggest approaches for minimising racism’s adverse health impacts. Methods: Literature review and conceptual frameworks based on the historical, structural and social determinants of health and health care were used to highlight the scope and ramifications of racism in relation to health, and to Indigenous health care access. Results: Racism has major adverse impacts on the health of Indigenous Australians, and significantly hinders their access to effective health care. Most of racism’s negative effects on Indigenous health may be ameliorated through addressing structural determinants of health inequities, improving community awareness regarding racial prejudice, strengthening political will to address racism, improving cultural competence among health workers, and health service redesign to facilitate optimal access to Indigenous health care. Conclusions: A feasible, integrated approach for addressing negative health consequences of racism on health and health care access should involve all stakeholders working cooperatively to minimise adverse impacts of its proximal (e.g. stereotypes and prejudice), distal (e.g. imprisonment and education) and contextual (e.g. politico-legal) determinants. Implications: Sustainable and effective approaches to address racism’s impacts on Indigenous health and healthcare access may be achieved by addressing structural determinants of health inequities. Multifaceted anti-racism interventions demand active participation by Indigenous people, governments, a culturally competent health workforce, all Australians, and the international human rights community.