Background: A vital component of high-quality palliative and end-of-life care is Advance Care Planning (ACP). The positive role of ACP in healthcare is widely recognised. Despite this evidence, ACP is not commonplace among First Nations (FN) peoples.

Objectives of research: To outline knowledge gaps, research conducted, scope of literature, and the evidence available regarding ACP with First Nations peoples in Australia and New Zealand (Aboriginal, Torres Strait Islander and Māori).

Methods: Systematic search strategies were developed to explore five electronic databases and the grey literature. No limits were applied to the year of publication. Studies of First Nations peoples or Māori adults that involved ACP, comprising observational or interventional studies, and discussion surrounding end-of-life wishes were included. Screening was undertaken by two independent researchers. Data extraction and quality assessment using a culturally appropriate appraisal tool were undertaken by an independent researcher (IK).

Results: Of 732 articles retrieved, after screening and full-text review there were 9 included studies. At end-of-life, First Nations peoples prefer to die at home. Cultural, community and relationship values shape First Nations peoples engagement in ACP discussions. Outcomes in some studies have suggested benefits from ACP, such as avoiding unnecessary hospital admissions and increased healthcare satisfaction.

Conclusions: ACP education and communication needs to be culturally tailored to First Nations peoples to enhance ACP engagement. Understanding First Nations’ end-of-life wishes, cultural, relationship and service provider influences on preparing an ACP could inform future policy and community efforts to improve ACP uptake and use among First Nations peoples.