To examine inequalities in health status of Registered First Nations Manitobans compared to all other Manitobans. Three mortality indicators--premature mortality rate (PMR) defined as an age- and sex-adjusted rate of death before age 75 years; life expectancy from birth; and potential years of life lost (PYLL)--are compared between Registered First Nations (RFN) people and all other Manitobans (AOM) by geographical areas of Manitoba. Data were derived from the Population Health Research Data Repository, linked to the federal Status Verification System (SVS) files for the years 1995 through 1999. First Nations experienced double the PMR compared to all other Manitobans (6.6 versus 3.3 deaths per thousand, p < 0.05), an eight-year gap in life expectancy (males: 68.4 versus 76.1 years; females 73.2 versus 81.4 years), and over twice the PYLL (males 158.3 versus 62.5 years of life lost per thousand; females 103.3 versus 36.5). RFN male life expectancy was geographically-related (better health status in the north), and inversely related to the corresponding regional AOM life expectancy (r = -0.61, 9 df, one-tailed, p < 0.03). As regional percentage of RFN decreased, male life expectancy decreased (r = 0.77, 9 df, one-tailed, p < 0.003). In contrast, RFN female indicators showed no such relationship. The inequality in health status between RFN and all other Manitobans is large, but also shows differential geographical and gender effects.