Purpose: Indigenous Australians (Aboriginal and/or Torres Strait Islander) have lower overall survival from Lung Cancer, compared to non-Indigenous Australians. Indigenous Australians receive higher rates of chemotherapy and/or radiotherapy. The equity of peri-operative care, and thoracic surgical outcomes in Australian Indigenous populations have not been contemporarily examined. Methods: We performed a retrospective registry analysis of the Queensland Cardiac Outcomes Registry (QCOR), Thoracic Database examining all adult lung cancer resections across Queensland from 1/1/2016- 22/4/2022. Examining the time from diagnosis to surgery, operative data and postoperative morbidity and mortality, comparing Aboriginal and/or Torres Strait Islander People, with non-Indigenous Australians. Results: There were 31 patients (2.56%) of 1208 who identified as Indigenous. Mean age at surgery was 68.2 years vs 66 in the Indigenous and non-Indigenous, respectively(p=0.23). There was a female predominance in the Indigenous patients (n=28, 90.32%, p<0.01) and the average BMI was lower (22.52 vs 27.09, p<0.01). There was no variation in the surgical parameters or histopathological distribution of cancer type between groups. Multivariable logistic regression analysis suggested that Indigenous patients were at elevated risk of blood transfusion (RR 3.9, P= 0.014, OR 9.01, 95%CI 2.25-36.33, P<0.01) and had greater transfusion requirements (RR 4.08, p= 0.0116 & OR 12.67, 95%CI 2.25-71.49, P<0.01), however the influence of low absolute number transfusions must be acknowledged here. Indigenous status was not associated with increased ICU admission (OR 1.79, 95%CI 0.17-18.80, p=0.62), return to theatre (OR 2.1 95%CI 0.24-18.15, p=0.50), new atrial fibrillation (OR .52 95%CI 0.07-4.01, p=0.55), prolonged air-leak (OR 0.29, 95%CI 0.04- 2.16, P=0.228) or pneumonia postoperatively (OR 4.77, 95%CI 0.55-41.71, p= 0.16). With only 3 deaths, no meaningful trends were observed. Time from diagnosis to surgery was comparable in the Indigenous and non-Indigenous groups (88.6 days, 95% CI 54.26-123.24 vs 86.2days, 81.40-91.02 p=0.87). Post-operative length of stay was not numerically or statistically different between groups. (Indigenous; 7.54 days vs non-Indigenous; 7.13 days, p=0.90). Conclusions: Indigenous patients are more likely to receive a blood transfusion than non-Indigenous patients during lung resection. Reassuringly the care peri-operative provided to Indigenous Australian’s undergoing lung resection in Queensland appears to be comparable to that of the non-Indigenous population.