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Aim Increasing Māori and Pacific success into and through tertiary health professional study has been prioritised as a key element in addressing inequitable health outcomes. However, secondary and tertiary education providers are failing to ensure Māori and Pacific student success. This study aimed to explore the effect of pre-tertiary, admission and early academic outcome variables on academic outcomes within tertiary health study. Methods Kaupapa Māori methodology, consistent with Kaupapa Pasifika methodology, was used to conduct a quantitative analysis of demographic and academic data for Māori, Pacific and non-Māori non-Pacific students enrolled in the Faculty of Medical and Health Sciences at the University of Auckland between 2002 and 2012. Multiple regression analysis was used to explore the effect of predictor variables including: school decile (low, medium, high); Auckland school (yes, no); type of admission (school leaver, alternative admission); bridging foundation programme (yes, no); first year bachelor grade point average (GPA); and first year bachelor passed all courses (yes, no); on academic outcomes (first year bachelor GPA, year 2 – 4 programme GPA, graduated from intended programme, graduated in the minimum time) and a composite optimal completion outcome for Māori, Pacific and non-Māori non-Pacific student groupings. Findings A total of 2686 students (150 Māori, 257 Pacific, 2279 non-Māori non-Pacific) who enrolled in the Bachelor of Health Sciences, Bachelor of Pharmacy and Bachelor of Nursing programmes between 2002 and 2012 were included. Māori and Pacific students were more likely to …