The uranium industry in the American Southwest has had profoundly negative impacts on American Indian communities. Navajo workers experienced significant health problems, including lung cancer and nonmalignant respiratory diseases, and psychosocial problems, such as depression and anxiety. There were four uranium processing mills and approximately 1,200 uranium mines on the Navajo Nation's over 27,000 square miles. In this paper, a chronology is presented of how uranium mining and milling impacted the lives of Navajo workers and their families. Local community leaders organized meetings across the reservation to inform workers and their families about the relationship between worker exposures and possible health problems. A reservation-wide effort resulted in activists working with political leaders and attorneys to write radiation compensation legislation, which was passed in 1990 as the Radiation Exposure Compensation Act (RECA) and included underground uranium miners, atomic downwinders, and nuclear test-site workers. Later efforts resulted in the inclusion of surface miners, ore truck haulers, and millworkers in the RECA Amendments of 2000. On the Navajo Nation, the Office of Navajo Uranium Workers was created to assist workers and their families to apply for RECA funds. Present issues concerning the Navajo and other uranium-impacted groups include those who worked in mining and milling after 1971 and are excluded from RECA. Perceptions about uranium health impacts have contributed recently to the Navajo people rejecting a resumption of uranium mining and milling on Navajo lands. Health Phys. 101(5): 618-625; 2011