Health literacy, although diversely defined, refers to the abilities, relationships and external environments required for people to successfully promote health. Existing research suggests that health literacy is related to health inequities, including individual and community capacity to navigate health. A diverse range of factors shape health literacy abilities and environments, especially culture, gender and age. However, the nexus between these variables and their cumulative impact on health literacy development remains largely unexplored. Commentary that explores these dynamics among young Indigenous males is particularly scant. In turn, strategies to bridge health equity gaps have been obscured. This article brings together disparate research on health literacy, masculinities, youth studies and men’s health in order to address this oversight. By outlining the collective conceptual contribution of these strands of scholarship, we show that young Indigenous males navigate health literacy through a complex cultural interface that balances both Western and Indigenous understandings of health. Alternative masculine identities, which simultaneously embrace and resist components of hegemonic masculinity, also shape this health literacy lens. We explain that the development of health literacy is important for young people, particularly young Indigenous males, and that this is negotiated in tandem with external support structures, including family and friends. By describing these intersections, we explore the implications for researchers, policymakers and practitioners seeking to achieve the dual goal of improving health literacy and reducing health inequities among this highly marginalised population.