This article reviews the development of the national Indigenous performance measurement system over the last decade. Data were collected from the published and unpublished literature and review of government websites, facilitated by key informant interviews which provided information about the policy context. A number of innovations have occurred over the last decade, including the development of a conceptual framework to underpin a system-wide approach to performance measurement that is aligned with nationally agreed strategic goals. The development of mechanisms to oversee Indigenous health strategy and health data development create formal mechanisms that potentially link data development and performance measurement priorities. Innovation in the development of processes to support health system performance improvement is evident, but this needs to be prioritised, particularly with respect to those components of the health system that are not Indigenous-specific.