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Introduction: There have been no published studies reporting health utilities among Aboriginal people attending residential rehabilitation for substance use treatment. This study aims to examine health utilities for Aboriginal people in residential rehabilitation and investigate the association between health utilities and length of stay. Methods: EuroQol‐5 Dimension 5‐level (EQ‐5D‐5L) raw data collected from three residential rehabilitation services in New South Wales, Australia was transferred into a quality‐adjusted health index using EQ‐5D‐5L Crosswalk Index Value Calculator. Clients were categorised into two groups based on their length of stay in treatment: ≤60 days or more than 60 days. Among people who stay longer than 60 days, we also examined health utilities by exit status (yes/no). Bootstrapping was used to examine the difference in improvement in health utilities from baseline to the latest assessment in both groups. Results: Our study included 91 clients (mean age 32 years old SD: 9). Mean health utility at baseline was 0.76 (SD 0.25) and at the latest assessment was 0.88 (SD 0.16). For clients staying 60 days, the incremental health utility was 0.13 (95% confidence interval [CI] 0.06–0.20; p < 0.01). For clients staying less than or equal to 60 days, the incremental health utility was 0.12 (95% CI 0.00–0.24; p = 0.06). For the total sample, the incremental health utility was 0.12 (95% CI 0.06–0.19; p < 0.01). Discussion and Conclusions: There is a significant improvement in health utilities for people staying longer in residential rehabilitation. Strategies to improve treatment retention could potentially increase quality of life for Aboriginal people in residential rehabilitation. [ABSTRACT FROM AUTHOR]