Collectively, critical approaches aim to: ‘understand and to disrupt notions of truth and the structures of power that come to be taken for granted’. Common critical theories that inform critical approaches include critical theory, critical realism, race, class or cultural theory, gender and queer theory, and feminism theory. Critical analysis leads to the uncovering and dismantling of omissions and invisibilities, paying increased attention to power, privilege, and hierarchy. This chapter explores and discusses the philosophical underpinnings of critical approaches to health professions education research — historical realism ontology, collectivist and subjectivist epistemology, and the emancipatory axiology or values underpinning this approach. It outlines key quality indicators, including guidelines that may support the appraisal of critical research. Key strengths of critical approaches include the potential for reciprocal benefits for researchers and participants in that there is two-way learning through this dual process of trust and reciprocity.