Gambling impacts upon the health, wellbeing and finances of many people throughout Australia. This study aimed to explore the socioeconomic and cultural factors linked with gambling in urban and remote Indigenous settings in the Northern Territory to inform the development of a gambling public health strategy. The Aboriginal and Islander Mental Health Initiative developed a semi-structured questionnaire with Aboriginal partner organisations following consultation. Indigenous consumers of substance use treatment facilities participated in focus group discussions and key informant interviews were conducted with nine service providers at two time points, a year apart. Participants described key strengths in community as family, health and culture, while key worries included substance misuse, health concerns and family disharmony. Regulated gambling and card playing were also identified as important community worries. Financial and family concerns and addictive behaviour were seen as negative consequences of gambling. There was increasing concern linked with card playing and electronic gaming machines and an increased call for awareness campaigns, support from government for change and greater regulation. The findings of this study provide the most recent insight into attitudes, behaviours and consequences linked with Indigenous gambling in the Northern Territory.