Food insecurity among Indigenous peoples in Canada is a significant public health issue, impacting all four pillars of food security: availability, access, utilization, and stability. A literature review identified 91 studies indicating that economic disadvantages, high food prices, lack of transportation, and climate change are major contributors to food insecurity. Traditional food systems are disrupted by loss of knowledge, poor food quality, and food safety concerns. Addressing these issues requires culturally specific integrated approaches to improve food availability, cost, knowledge, and quality.