Abstract Background Indigenous (First Nations, Inuit, or Métis) children represent the future of their strong cultures and resilient communities. However, medical colonialism, anti-Indigenous racism and other structural and environmental determinants of health have contributed to ongoing disparities in hospital care for Indigenous compared to non-Indigenous children. Few studies have examined the care and services addressing the needs of Indigenous children and their families in the hospital setting. Objectives The overall goal of our study was to conduct an environmental scan of services specific to Indigenous children and families in children’s hospitals across Canada. Design/Methods Our team of researchers, scholars, and clinicians (Indigenous and non-Indigenous) conducted an environmental scan of services specific to Indigenous children and families in all 15 children’s hospitals across Canada within the infrastructure of the Canadian Paediatric Inpatient Research Network (PIRN) and the Pediatric Outcomes imProvement through COordination of Research Networks (POPCORN). We collected data from publicly available documents and conducted semi-structured interviews with healthcare practitioners, service providers, and administrators between June and November 2024. Nineteen interviews (5 Indigenous, 14 non-Indigenous participants) were conducted across 14 out of 15 eligible children’s hospitals. Data were analyzed using reflexive thematic analysis. Results There was considerable variation in the services for Indigenous children and families provided by children’s hospitals. Most are working with multiple external community agencies to meet the needs of Indigenous children and families. Few have implemented smudging policies and Indigenous (physical) spaces. We observed gaps in institution-led strategic approaches to Indigenous health, hospital data collection on Indigenous identity, care and outcomes, and the recruitment and retention of Indigenous staff. There are variations in the implementation of cultural safety, the role of Indigenous patient navigators, and physician knowledge on the various services available. Conclusion Most participants requested to learn about the programs and policies that exist and participate in the knowledge exchange of study findings. By sharing the successes and challenges of current Indigenous-specific services identified, we aim to advance the agenda for the TRC: Calls to Action, Joyce’s Principle, and cultural safety in Canadian children’s hospitals. Next steps may include identifying the needs, benchmarks, and best practices to support Indigenous children and their families in the hospital setting.