Purpose Although Māori and Pacific populations are overrepresented in obesity-related diseases, there is a lack of research exploring the inequities present within bariatric surgery outcomes. This systematic review examines weight loss and bariatric surgery outcomes – identifying any preventable disparities and key themes. Methodology A Kaupapa Māori-aligned systematic review was undertaken, searching PubMed, Scopus, Embase, Medline CINAHL, and Cochrane for studies published since 2000 and onward. Papers excluded were case reports, non-New Zealand studies, conference abstracts, and editorials. Papers were screened and assessed using MMAT, adapted CONSIDER framework, and MAORI framework. Results 334 papers were screened, with 101 full texts assessed. A total of 74 studies met the inclusion criteria. The most common study designs were retrospective cohort studies (19%). Bariatric surgery was consistently associated with improved health outcomes and significant diabetes remission rates. However, Māori population representation was reported in just under 50% of studies, with inclusion rates ranging from 14% to 31%. Very few of the studies address culturally responsive methodologies, participation, or dissemination practices, performing low within the CONSIDER and MAORI frameworks. These findings highlight both the clinical benefits of bariatric surgery and the need for greater equity in research and surgical practices. Conclusion This study highlights the limited research undertaken to reveal the systemic disproportionate disparities within bariatric surgery outcomes in Aotearoa New Zealand. This review emphasises the need for quality research to confront these inequities, in hopes of implementing systemic and policy change.