ISSUES ADDRESSED: To determine cardiovascular health benefits in Indigenous men following short-duration small-sided games. METHODS: Fourteen sedentary Indigenous males (35.6 SD 7.2 years), randomly assigned to a small-sided games (SSG) or a non-exercising control. Small-sided 20-minute (4 x 5 minute bouts) games of touch football were played 2 x/week for 9 weeks. Waist and hip circumferences, height, total body mass (kg), fat (%), fat free mass (kg), muscle mass (kg), resting heart rate (bpm), systolic blood pressure (mmHg), total cholesterol and high-density lipid concentrations were measured and waist-hip ratios, body mass index (BMI), heart rate variability (HRV), metabolic age and Framingham risk calculated before and after the exercise intervention. Between group differences were examined using unpaired t tests (welch corrected) and described using Cohen\'s effect size (ES) differences (corrected to determine hedges g). RESULTS: Significant between group differences favouring the SSG group were observed in body mass (P = .039, ES = 0.18), BMI (P = .031, ES = 0.22) and metabolic age (P = .033, ES = 0.29) and in HRV parameters of approximate entropy (ApEN; P = .01, ES = 1.65) and sample entropy (SampEN; P = .0193, ES = 1.40). CONCLUSION: Middle-aged Indigenous men can gain cardiovascular health benefits following short bouts of small-sided game play accumulating in 40-minutes of exercise each week. SO WHAT?: Short-duration SSG may address many exercise barriers, and offer a sustainable form of exercise to improve cardiovascular health amongst Indigenous men.