For the Syilx Okanagan Nation, food sovereignty is foundational to ensuring their cultural food security and health. Salmon being a central Syilx food, the Nation has worked relentlessly since the 1990s to reintroduce Okanagan sockeye salmon into their traditional territory. This study describes the reach of this initiative and assesses its impact on Syilx households’ income-related and cultural food security status. In total, 265 households participated in the study. Overall, 48.6% of participants ate Okanagan sockeye salmon during the year prior to the survey. Most participants (89.1%) reported that during the prior year their household accessed salmon from a community member or through trade (53.7%), community program (49.8%), a feast or ceremony (35.8%), or household harvest (27.2%). The number of ways that households accessed salmon was associated with a greater frequency of salmon consumption (p < 0.0001). Income-related (46.5%) and cultural (63.1%) food insecurity were prevalent. Households’ access to salmon was significantly associated with cultural food security and the perceived importance of cultural food security. This study suggests Indigenous food sovereignty initiatives can increase traditional food access and consumption, thereby enhancing cultural food security. They should be supported by governments, organizations and corporations.