This paper assesses the risks and opportunities for Indigenous interests embedded in the recommendations of the recent independent review into the National Disability Insurance Scheme (NDIS). To provide essential context, the paper begins with an overview of the mainstream policy issues emerging from the NDIS Review, before addressing the distinct issues relevant to Indigenous interests. The proposed reforms create significant opportunities to remove the structural and system constraints inhibiting equitable access by Indigenous people to disability support by governments. However, each opportunity also entails risks, and the risks of policy failure are substantial. The paper argues that the NDIS Review’s recommendations are both essential to the long-term sustainability of the NDIS, and in the public interest. Yet for Indigenous interests to grasp the opportunities and avoid the risks embedded in the Review’s complex policy architecture and implementation processes, they will need to develop a comprehensive and proactive response focused on implementation of the proposed reform agenda, and engage in sustained advocacy across all jurisdictions in order to ensure the reform momentum is maintained.