Purpose: Māori are significantly underrepresented within the surgical workforce in Aotearoa New Zealand, contributing to persistent inequities in access, experiences, and outcomes of surgical care. While barriers for minority groups in surgery have been described, little is known about Māori experiences across the full pathway from medical school to consultancy. This study aimed to explore Māori doctors’ experiences to identify barriers, enablers, and opportunities to strengthen pathways into surgery. Methods: A national qualitative study was undertaken using a Kaupapa Māori methodological approach. Māori medical students, junior doctors, and registrars completed an online survey exploring motivations, barriers, and access to support. Semi-structured interviews were conducted with Māori surgical consultants nationwide. Interviews were grounded in tikanga Māori, incorporating whakawhanaungatanga and karakia, and were transcribed verbatim. Data were analysed using thematic analysis Results Five key themes were identified: (1) early exposure and commitment to improving Māori health as motivators for pursuing surgery; (2) the central role of culturally grounded mentorship, particularly from Māori senior clinicians; (3) systemic and interpersonal racism influencing training experiences and career decisions; (4) cultural tension and imposter syndrome when navigating predominantly Pākehā surgical environments; and (5) the need for stronger, coordinated pipeline support from medical school through to consultancy. Māori-led initiatives, including interview preparation wānanga, were identified as effective enablers of progression. Conclusion Māori pursuing surgical careers face persistent systemic and cultural barriers across the training continuum. Strengthening culturally grounded mentorship, addressing racism within training structures, and implementing coordinated pipeline approaches are critical to improving Māori representation and equity within the surgical workforce.