A recent Lancet publication reported the substantial and largely unmet health needs of Australian Aboriginal and Torres Strait Islander (Indigenous) adolescents; needs that we have been working tirelessly to address in the Northern Territory. In order to improve health outcomes for Indigenous adolescents, we must create health systems responsive to their needs. This paper focuses on changes made at Royal Darwin Hospital, which continue to improve the quality of care for this group. We describe these changes here, to celebrate the gains made and ultimately, we hope, to help address the health of Indigenous adolescents more broadly.