Indigenous peoples are overrepresented in correctional systems internationally, reflecting a history of systemic racism and colonial oppression, and the practice of risk assessment with this population has been a focus of legal and sociopolitical controversy. We conducted a systematic review and meta-analysis of the risk assessment literature comparing Indigenous and non-Indigenous (White majority) groups. We retrieved 91 studies featuring 22 risk tools and 15 risk/need/cultural domains (N = 59,693, Indigenous; N = 237,729, non-Indigenous/White) and four documents identifying culturally relevant factors. Most measures demonstrated moderate predictive validity but often had significant ethnoracial differences, particularly for static measures. The Service Planning Instrument/Youth Assessment Screening Inventory, Level of Service Inventory youth variants, Psychopathy Checklist-Revised and Youth Version, and the Violence Risk Scale and its Sexual Offense version had the strongest predictive validity and least ethnoracial discrepancy. The Static Factors Assessment and Dynamic Factors Identification and Analysis-Revised had the weakest predictive validity. For Indigenous persons, the strongest individual predictors of recidivism were low education/employment, substance abuse, antisocial pattern, and poor community functioning, while mitigating factors that predicted decreased recidivism were measures of risk change (i.e., from culturally integrated programs combining mainstream and traditional healing approaches), cultural engagement/connectedness, and protective factors. In practice, static measures need to be supplemented with dynamic ones, and assessors should select measures with at least moderate predictive validity and ideally the least ethnoracial bias. These conclusions are tempered by the quantity and quality of the literature coupled with the circumstance that some study authors have coauthored tools in this review. Public Significance Statement Most risk assessment measures can predict reoffending with a reasonable (i.e., moderate) level of accuracy for Indigenous people undergoing risk assessments in the justice system; however, these measures often have better accuracy when used with non-Indigenous (and primarily White) clients, particularly static measures that are heavily based on criminal history. The "best" potential measures tend to be dynamic tools, as these have less prediction bias, can drive services, measure reductions in risk (e.g., with culturally integrated treatment programs), and inform release decisions and community supervision strategies. Of note, other unmeasured or non-risk-relevant factors (e.g., overpolicing, aggressive prosecution) can inflate recidivism estimates for Indigenous peoples and decrease predictive validity of risk measures, which should be considered when conducting risk assessments. Careful, critical examination of current risk measures and further research is necessary to increase fair, humane, and ethical use of these measures with Indigenous clients in forensic, correctional, and legal settings.