There are global calls to improve health professions education design to assist in strengthening healthcare equity for Indigenous peoples. This case study aimed to investigate Aboriginal health curriculum design and development occurring across a large urban health faculty in Australia. This was achieved by auditing curricula for 9 years and narrating events occurring alongside this. Decolonising, Indigenising, and critical Indigenous studies are three relevant and often recommended educational theories and approaches for higher education curriculum design. However, gaps exist in understanding how these approaches can be applied in health professions education. This case study began with aspects of an Indigenising approach which for several reasons proved impractical to employ. Problematically, embedded curriculum focused on viewing Aboriginal peoples and cultures as barriers to healthcare equity. Multiple drivers began influencing a shift to decolonising and critical Indigenous studies approaches. The shift created benefits, such as, stronger Indigenous governance and the study of colonial power. Additionally, the shift reduced some burdens on Aboriginal educators, gave non-Aboriginal educators clearer responsibilities and built educator coalitions. It also repositioned piecemeal and fragmented curriculum to denser curriculum with greater curriculum framework coverage. Consistent with decolonial approaches, the curriculum design will require ongoing iterative review and change.