<p>Art is increasingly recognized as emotionally therapeutic for patients but is also a deeply spiritual medium which can promote health and well-being. There is a need to advance equity-oriented arts-based spiritual support in healthcare services to better meet the needs of diverse patients. The purpose of this paper is to carry out a philosophical analysis at the juncture of art, spirituality, health, and equity to understand their interconnectedness and demonstrate how arts-based spiritual support can reify or disrupt health inequities in Canada. We address three questions arising at this juncture: <i>What are the philosophical grounds for integrating art and spirituality for health and well-being in an equitable way? How has the relationship between art and spirituality been theorized? What is the interplay between social identity factors and arts-based spiritual support in relation to inequities in healthcare?</i> Arising from our analysis, we propose that a sustained commitment to equity and decolonization, intersectionality, trauma-and-violence-informed care, and respectful partnerships is essential to ensuring responsive and inclusive art and spirituality initiatives amid growing social and health inequities.</p>