In June 2013, a severe flooding of the Bow and Elbow Rivers affected southern Alberta, a province in Canada. The flood was subsequently described to be the costliest natural disaster in Canadian history. Among the hardest hit communities was the Siksika First Nation, located on the Bow River banks about 100 kilometers east of the city of Calgary. A community-university partnership was formed to qualitatively document the Siksika First Nation community-based response to the health and social impacts to their community resulting from the flood. Our findings informed the development of a culturally appropriate framework for disaster and emergency planning in First Nations communities. The Siksika Nation's work to mitigate the impacts from the flood followed a holistic and socio-ecological approach that took the determinants of Indigenous peoples' health into consideration.