Australia is a country blessed with a high standard of living, long life expectancy and an excellent health care system. Yet Australia’s Indigenous population experiences social and economic disadvantage and has much worse health outcomes, including shorter life expectancy, than the non-Indigenous population. This has led to a national focus on “Closing the Gap” of Indigenous disadvantage, but despite considerable investment and attention, little progress is being made. Rheumatic heart disease is an exemplar disease of “the Gap”. Borne of socio economic disadvantage, it occurs at among the highest rates in the world in Indigenous Australians living in regional and remote areas, and is the leading cause of differential cardiovascular disease burden, and among the top 5 causes of overall differential burden, between Indigenous and non-Indigenous Australians. Considerable progress has been made in improving care for people living with RHD, but not in reducing overall RHD burden, despite more than two decades of collaborative research and RHD control programs. Recognising that a more comprehensive approach is needed, researchers, service providers and community stakeholders are partnering in END RHD – an alliance of research, service and community organisations taking a three-pillared approach (research, evidence based policy recommendations (the “Endgame Strategy”) and advocacy) in the hope of eliminating RHD as a public health issue of importance in Australia.