This study systematically reviewed evidence regarding health program and service evaluations in Indigenous contexts. Following the PRISMA guidelines and combining terms for 'Indigenous populations' and 'health programs and services'. Eight principles emerged: Principle 1: Adopting Indigenous led or co-led approaches is vital to balance power relationships by prioritizing self-determination, Principle 2: Evaluation team should include local Indigenous community members, Principle 3: Indigenous community knowledge and practice should be foundational, Principle 4: Evaluations must be responsive and flexible to meet the needs of the local community, Principle 5: Evaluations should respect and adhere to local Indigenous protocols, culture, wisdom and language, Principle 6: Evaluations should emphasize reciprocity, shared learnings and capacity building, Principle 7: It is important to build strong relationships and trust between and within researcher teams, evaluators and communities, and Principle 8: The evaluation team must acknowledge community capacity and resources by investing in time and relationships.