Co-design is becoming a well-known term outside of the design domain, reflecting a growing awareness of the potential and value of applying a design-led process to address complex social and systemic issues. However, an increase in the adoption of ‘co-design’ methods has also led to multiple and sometimes conflicting understanding of what it means and how it is enacted in practice. ‘What does genuine co-design mean? What does it look like? And how does it make a difference?’ – we have been exploring these questions through our participatory design practice and research spanning over seven years. In this chapter, we share our learnings and reflections on genuine co-design, using examples to articulate characteristics of co-design and conditions for enabling genuine participation in the co-design process. We invite further dialogue with the wider practice and research communities to develop a shared understanding of what is (and what is not) genuine co-design.