This narrative review highlights evaluation approaches, principles, and frameworks for chronic disease interventions in North American Indig-enous contexts. It aims to inform the co-development of an evaluation frame-work for two studies focused on improving diabetes and obesity outcomes for urban Indigenous communities. This review uses a Two-Eyed Seeing perspective that brings Indigenous and Western ways of being, knowing, and doing together. There is a paucity of published evaluation frameworks inclusive of both per-spectives. The themes identified here suggest that evaluation approaches should address gender equity issues, be participatory, be grounded in local context, traditions, and knowledge, and be responsive to community-identified needs and solutions.