Background: Nontuberculous mycobacteria (NTM) are environmental pathogens causing pulmonary and extrapulmonary infections. First Nations people in Australia experience higher burdens of communicable diseases, comorbidities, and systemic barriers to care, increasing NTM risk. This study examined the incidence and spatial distribution of NTM infections in First Nations people in Queensland. Methods: A retrospective longitudinal analysis was conducted using NTM notifications from the Queensland Health Notifiable Conditions Database, stratified by Indigenous status. Incidence was calculated using population denominators and Indigenous Region boundaries, with direct rate comparisons between 2011 and 2024. Results: Between 2001 and 2024, 717 NTM notifications were recorded from 606 First Nations people, with a significant male predominance among those aged 30-44 years ({chi}^2=21.63, P