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River systems globally are experiencing social-ecological changes that often impact Indigenous fishing practices, including climate change and resource developments. We explore the relationship between access to fish and well-being, and the determinants of access to fish amidst changing social-ecological conditions through interviews with 29 individuals across four Gwich'in First Nation communities in Canada's Northwest Territories. Our interviews show that socioeconomic and environmental barriers are making it harder to access fish and that this has negative implications for well-being. Despite these barriers, access to fish continues to make positive, diverse contributions to well-being in Gwich'in communities through socioeconomic factors such as sharing networks and adaptive practices that are often part of ecological monitoring and land-based education and facilitate access to fish. Increasing our understanding of the relationship between access to fish and well-being, and determinants of access to fish, can contribute to land-based programs, land-use planning, and decision-making in Gwich'in territory and other river systems. [ABSTRACT FROM AUTHOR]