Purpose-The purpose of this paper is to explore the concept of co-creativity in relation to artistic practice with people with a dementia. The aim of the discussion is to outline how co-creativity offers fresh approaches for engaging artists and people with dementia, can contribute to less restrictive understandings of "creativity" and above all, expand the understanding of people with a dementia as creative, relational and agential. Design/methodology/approach-In order to examine current conceptions of co-creativity and to inform the artistic practice, relevant literature was explored and eight expert interviews were conducted. The interviews were thematically analysed and are included here. Findings-This paper consequently demonstrates that improvisation, structure, leadership and equality are central elements of co-creative processes and outlines how co-creativity can offer fresh insights into the way in which the arts can engage people with a dementia, the relationship between creativity and dementia and the transformative potential of the co-creative arts for those living with a dementia. Research limitations/implications-The paper discusses some of the difficulties that are inherent a co-creative approach, including power relations and the limitations of inclusivity. Due to ethical restrictions, the paper is limited by not including the perspectives of people living with a dementia. Practical implications-This paper paves the way for future research into co-creative processes in a variety of different contexts. Social implications-A more nuanced understanding of co-creativity with people with dementia could challenge the dominant biomedical and social paradigms that associate "dementia" with irretrievable loss and decline by creating opportunities for creative agency. Originality/value-This exploration of co-creativity with people with dementia is the first of its kind and contributes to the wider understanding of co-creativity and co-creative practice.