OBJECTIVE: To evaluate the utility and outcomes for Indigenous and non-Indigenous patients requiring domiciliary oxygen therapy. DESIGN: Retrospective study. SETTING: Patients residing in the regional and rural Top End Health Service region of the Northern Territory of Australia. PARTICIPANTS: Indigenous and non-Indigenous patients prescribed domiciliary oxygen therapy between 2018 and 2020. INTERVENTIONS: Demographics and clinical indication for domiciliary oxygen therapy and mortality were analysed. MAIN OUTCOME MEASURES: Differences between Indigenous patients requiring domiciliary oxygen therapy in comparison with their non-Indigenous counterparts. RESULTS: Of the 199 study participants, the majority were male (51%), non-Indigenous (77%) and urban residents (72%). Overall chronic obstructive pulmonary disease was the most common indication for domiciliary oxygen therapy (51%) followed by palliative intent (22%). Indigenous patients were significantly younger (61 vs 73 years), with a higher proportion of males (62% vs 45%, P = .039) and remote residents (62% vs 8%, P < .001). Among Indigenous patients, a significantly greater proportion of domiciliary oxygen therapy was indicated for chronic obstructive pulmonary disease and bronchiectasis (16% vs 1%, P < .001). Among non-Indigenous patients, malignancies were a more common indication for domiciliary oxygen therapy. A similar proportion of Indigenous and non-Indigenous patients were prescribed domiciliary oxygen therapy for palliative intent (31% and 20%, P = .108); however, the underlying diagnosis differed significantly, with a greater proportion of chronic obstructive pulmonary disease among Indigenous patients (43% vs 13%, P = .030) and malignancy among the non-Indigenous patients (73% vs 43%, P = .050). Mortality and length of survival were not significantly different by Indigenous status. Linear regression showed longer survival with domiciliary oxygen therapy for chronic obstructive pulmonary disease. CONCLUSION: Indigenous Australian patients living in remote communities will likely derive the same benefits and outcomes of domiciliary oxygen therapy as non-Indigenous peers.