Widening access to highly competitive and restricted health professional programmes of study such as medicine, pharmacy and optometry remains a challenge for many tertiary institutions. Understanding the role that tertiary institutions can play to increase access for indigenous students remains important. This chapter explores the Vision 20:20 initiative based at the Faculty of Medical and Health Sciences (FMHS) at the University of Auckland, Aotearoa, New Zealand. Based on research findings and programme experience, twelve effective practices for tertiary institutional action are presented within the areas of: recruitment; admission; bridging/foundation education; and, retention. Tertiary institutions can (and should) support indigenous health workforce development via a commitment to tertiary interventions that are aligned to a widening participation and social justice agenda.