<p>Recent legislative changes have allowed the rapid expansion of online and sports gambling in Ontario. These changes include the privatization of the online and sports gambling market and the legalization of marketing practices for private operators, leading to an unprecedented growth in opportunities and inducements to gamble. While the stated objectives of these reforms centre on economic growth, consumer choice, and consumer protections, the potential public health implications of this policy shift demand urgent attention. This commentary argues for the necessity of applying a public health lens to understand the wide range of potential harms associated with Ontario’s gambling policy changes, particularly as other jurisdictions in Canada and across the Americas consider adopting similar approaches. It advocates for targeted research that reframes policy debates around gambling, moving away from a narrow focus on individual responsibility and towards a broader understanding informed by environmental, social, and commercial determinants of health. The public health community must step up to provide the public and decision-makers with the evidence needed to mitigate harm, protect vulnerable populations, and advance equitable health outcomes.</p>