Limiting global temperatures in line with the Paris Agreement requires deep and urgent cuts to emissions this decade from across all sectors, including healthcare. Yet, it can often take many years, even decades, for evidence from health research to be translated into practice. This article explores how researchers in the climate change and health field can and perhaps should operate in such an environment. Should they shift towards ‘action-oriented’ research? Should they pursue alternative pathways, such as advocacy? Should they take to the streets? First, I describe how value judgements can shape scientific research and discourse, and, in turn, policy and practice; I then discuss the recent history of advocacy amongst climate scientists and draw parallels with the experience of health researchers. Finally, I consider some possible ways to navigate the tensions between research and advocacy inherent to climate change and health research. I conclude that greater reflexivity upon the values underpinning our work on can help researchers navigate the challenges we face.