Disasters affect populations and ecosystems differently, depending on many factors such as socio-economic status, development practices, condition of the ecosystems, level of organization of the community and its human resources, and climate variability and extremes. Deteriorating environmental conditions in many parts of the world, whether due to climate change, unsafe development, or reduced investment in ecosystem protection is intensifying disaster risk, posing a growing threat to lives and development efforts. Disaster risk reduction involves the process of identifying, assessing and reducing the risks of these and other causal factors of disasters. This risk is exacerbated in vulnerable populations, which includes, among others, those who are often marginalized for economic or social reasons, inhabit unsafe lands, or lack access to information to reduce risk.Formalized disaster risk reduction information, such as plans, vulnerability maps, and even legislation and laws, is typically prepared by national or sub-national organizations, many of which are dominated by non-indigenous decision-makers. Indigenous peoples often do not have adequate opportunities to participate in their design, implementation, monitoring and evaluation. However, the consequences of disasters may well be more serious if at-risk populations are not taken into account and if means are not found to share, in culturally appropriate ways, strategies and best practices that respect the knowledge that exists in indigenous communities.The PAHO initiative on indigenous peoples and disaster risk reduction aims to increase knowledge and understanding of the disaster risks and needs faced by indigenous populations and develop culturally sensitive tools to better protect and improve their health during and after disasters. It is a first step, and draws on recommendations put forth by representatives of these populations in Latin America, the Caribbean, Canada and the United States. They were developed with the participation of a variety of disaster risk reduction professionals and representatives of indigenous populations in the Western Hemisphere and can be used by leaders of indigenous communities; national policy makers in ministries of health, indigenous affairs, planning and development, etc.; and international organizations that are currently taking steps (or planning to) to explore issues or develop programs that seek to reduce disaster risk in indigenous communities.