This documentary explores the experiences of Aboriginal Australians in modern Australia. The title is derived from the Aboriginal homeland community of Utopia, Northern Territory, one of the poorest and most desolate areas in Australia.

After almost three decades since he made a similar documentary, Pilger discovers that Aboriginal families are still living in extremely overcrowded and poorly sanitized asbestos shacks, and are plagued by easily curable diseases. The film goes on to explore some of the issues currently afflicting Australia such as; failed health policies, Aboriginal deaths in police custody, mining companies failing to share the wealth they have acquired with the first Australians and the disputed allegations made by the media and government that there were pedophile rings, petrol warlords and sex slaves in Aboriginal communities and the resulting 2007 intervention. The film also features a visit to Rottnest Island, Western Australia, where an area that was used as a prison for Aboriginal people until 1931, has now been converted into a luxury hotel where tourists are not even informed of the island's brutal history.