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Objective: This study aimed to examine how Indigenous patients and biomedical healthcare providers understand and experience the Indigenous wellness services at a hospital in the Northwest Territories., Methods: The qualitative study (May 2018-June 2022) was overseen by a regional Indigenous Community Advisory Committee. Guided by Two-Eyed Seeing and post-colonial theory, the study employed a community-engaged research design, and included two strategies for data generation: (1) interviews with Indigenous Elders, patient advocates, biomedical healthcare providers, policy makers, and hospital administrators (n = 41), and (2) iterative sharing circles with Indigenous Elders (n = 4). Data from the interviews and first sharing circle were transcribed, thematically analyzed, and presented to the sharing circle Elders for validation., Results: The study revealed three overarching and related themes: (1) Elders and patient advocates emphasized that while the Indigenous wellness services at the hospital play a pivotal role connecting patients with cultural supports, the hospital was still not effectively bringing Indigenous healing practices into hospital care; (2) participants identified that structural factors (i.e., policy and governance decisions) shaped patients' experiences with the wellness services; and (3) participants underscored that deeply rooted forces (i.e., racism, colonialism, and biomedical dominance) inhibit the integration of Indigenous healing practices., Conclusion: The findings extend understandings of hospital-based Indigenous wellness services by surfacing relationships between deeply rooted forces, organizational structures, and Indigenous patients' experiences. Altogether, they suggest that to advance care for Indigenous patients and improve the integration of Indigenous healing practices, a system-wide transformation is necessary, which includes Indigenous governance at the hospital and a recognition of the value of Indigenous healing practices., Competing Interests: Declarations Ethics approval This study received ethics approval from the University of Toronto’s Research Ethics Board (protocol no. 16705), a northern research licence from Aurora Research Institute (license no. 38649), and a research agreement with the Northwest Territories Health and Social Services Authority (NTHSSA). Consent to participate Informed consent was obtained from all individual participants included in the study. Consent for publication Not applicable. Conflict of interest The authors declare no competing interests., (© 2024. The Author(s).)