Participatory action research is evolving as both a research methodology and an intervention for health promotion. Here we describe its use in conducting a health assessment as part of a larger project for older Aboriginal women (hereafter known as the grandmothers). The overall purpose of the project was to study the women's health needs and respond through health promotion programming. The experience of using participatory action research revealed a number of lessons, including challenges and points of tension, and determinants and indicators of success. The research team identified some implications for consideration by others interested in participatory action research.