This listening session and roundtable discussion delve into the distinct needs and challenges confronted by tribal communities when undertaking overdose fatality reviews (OFRs) or engaging in neighboring jurisdictions’ OFRs. Throughout the session, participants will actively engage in discussions uncovering the barriers that impede the successful implementation of OFRs within tribal contexts. In addition, the session will highlight promising tribal approaches that can serve as models for initiating or enhancing OFRs. The outcomes of this discussion aim to shape future training, technical assistance, and resources to help tribes implement OFRs or partner with others effectively in this critical area. Seize this opportunity to enrich the collective understanding of tribal needs concerning OFRs, and play a pivotal role in advancing tribal capabilities in OFR implementation or enhancement.