ILO Convention No. 169 remains the only treaty open for ratification specifically and exclusively dedicated to the promotion and protection of indigenous peoples’ rights. Its cornerstone is the State’s duty to consult indigenous peoples. This article presents the history of the emergence of the duty to consult indigenous peoples in ILO Convention No. 169, its normative content and related guidance from the ILO supervisory bodies. It further examines developments with regard to this duty in the UN and the Inter-American systems and explores the relationship between such developments and ILO Convention No. 169. The paper revisits State practice of countries that have ratified that Convention, illustrating progress and challenges relating to the implementation of regulatory frameworks for consultation with indigenous peoples.