Despite being impacted by heritable conditions, Māori have been underrepresented in medical genomics both as participants and researchers. In addition, tikanga Māori (bioethics) and mātauranga (= Māori knowledge and concepts) have largely been ignored in research study design and conduct until relatively recently. This is despite traditional Māori societal structures being well suited to studying different categories of heritable conditions. Such lack of inclusion parallels a myriad of negative colonisation experiences, which, along with some more recent negative experiences of gene technologies and technologists, has left a legacy of distrust and unwillingness to participate in gene technology-based research. In the last few years a different approach has been undertaken to address underrepresentation: using tikanga-informed study designs we have (a) developed a variome resource for clinical and research applications to enhance hauora (Māori health) as well as (b) a data analysis platform that permissions both access and use of electronic health records, genomic information and Māori knowledge of genealogy (‘whakapapa’). Embedded in both of these tikanga-informed resources are the application and protection of whakapapa, which provides a basis for disease risk estimation in contemporary Māori populations using statistical methods that do not rely on large publicly accessible databases. Collectively, these approaches chart a uniquely Māori approach to precision medicine in Aotearoa/New Zealand that are enabled by concepts and protocols embedded in te ao Māori (the Māori world).