<p>Traditional gerontology has often been shaped by Euro-Western biomedical paradigms that define aging through decline, dependency, and individual burden. These models frequently overlook the lived experiences, knowledge systems, and culturally grounded roles of Indigenous and racialized Elders. This narrative review explores Indigenous and community-led frameworks that are reshaping gerontology through relational ethics, land-based knowledge, Elder leadership, and knowledge sovereignty. It highlights models that redefine aging as a socially connected, spiritually grounded, and collectively governed process. Drawing on five diverse case studies from Canada, Australia, India, Alaska, and transnational Indigenous contexts, this review synthesizes literature grounded in participatory, community-led approaches. A critical Indigenous-informed lens guided the thematic synthesis—foregrounding ethical relationships, cultural continuity, and resistance to biomedical dominance. Across all cases, shared themes included Elder leadership, land-based healing, knowledge sovereignty, and culturally rooted definitions of wellness. These frameworks offer conceptual alternatives to dominant models by reframing aging through interdependence, relational resilience, and community accountability. This review defines decolonizing gerontology as a paradigmatic shift—from biomedical decline and individualism toward relational, cultural, and land-anchored understandings of Elderhood. Rather than supplementing dominant paradigms, Indigenous and community-led models propose distinct, actionable frameworks for equity-based aging research, policy, and care.</p>