diff --git a/src/App.Metrics.AspNetCore.Health.Core/Internal/Authorization/AuthorizedHealthAuthorizationFilter.cs b/src/App.Metrics.AspNetCore.Health.Core/Internal/Authorization/AuthorizedHealthAuthorizationFilter.cs
new file mode 100644
index 00000000..40017d40
--- /dev/null
+++ b/src/App.Metrics.AspNetCore.Health.Core/Internal/Authorization/AuthorizedHealthAuthorizationFilter.cs
@@ -0,0 +1,15 @@
+// <copyright file="AuthorizedHealthAuthorizationFilter.cs" company="Allan Hardy">
+// Copyright (c) Allan Hardy. All rights reserved.
+// </copyright>
+
+using System.Threading;
+using Microsoft.AspNetCore.Http;
+
+namespace App.Metrics.AspNetCore.Health
+{
+  public class AuthorizedHealthAuthorizationFilter : IHealthAuthorizationFilter
+  {
+    /// <inheritdoc />
+    public bool Authorized(HttpContext context, CancellationToken token = default) { return true; }
+  }
+}
diff --git a/src/App.Metrics.AspNetCore.Health.Core/Internal/Authorization/IHealthAuthorizationFilter.cs b/src/App.Metrics.AspNetCore.Health.Core/Internal/Authorization/IHealthAuthorizationFilter.cs
new file mode 100644
index 00000000..e588b1e9
--- /dev/null
+++ b/src/App.Metrics.AspNetCore.Health.Core/Internal/Authorization/IHealthAuthorizationFilter.cs
@@ -0,0 +1,14 @@
+// <copyright file="IHealthAuthorizationFilter.cs" company="Allan Hardy">
+// Copyright (c) Allan Hardy. All rights reserved.
+// </copyright>
+
+using System.Threading;
+using Microsoft.AspNetCore.Http;
+
+namespace App.Metrics.AspNetCore.Health
+{
+  public interface IHealthAuthorizationFilter
+  {
+    bool Authorized(HttpContext context, CancellationToken token = default);
+  }
+}
\ No newline at end of file
diff --git a/src/App.Metrics.AspNetCore.Health.Core/Internal/Authorization/NotAuthorizedHealthAuthorizationFilter.cs b/src/App.Metrics.AspNetCore.Health.Core/Internal/Authorization/NotAuthorizedHealthAuthorizationFilter.cs
new file mode 100644
index 00000000..4e502061
--- /dev/null
+++ b/src/App.Metrics.AspNetCore.Health.Core/Internal/Authorization/NotAuthorizedHealthAuthorizationFilter.cs
@@ -0,0 +1,15 @@
+// <copyright file="NotAuthorizedHealthAuthorizationFilter.cs" company="Allan Hardy">
+// Copyright (c) Allan Hardy. All rights reserved.
+// </copyright>
+
+using System.Threading;
+using Microsoft.AspNetCore.Http;
+
+namespace App.Metrics.AspNetCore.Health
+{
+  public class NotAuthorizedHealthAuthorizationFilter : IHealthAuthorizationFilter
+  {
+    /// <inheritdoc />
+    public bool Authorized(HttpContext context, CancellationToken token = default) { return false; }
+  }
+}
\ No newline at end of file
diff --git a/src/App.Metrics.AspNetCore.Health.Core/Internal/Extensions/AppMetricsMiddlewareHealthChecksLoggerExtensions.cs b/src/App.Metrics.AspNetCore.Health.Core/Internal/Extensions/AppMetricsMiddlewareHealthChecksLoggerExtensions.cs
index 62fc2353..cac5577c 100644
--- a/src/App.Metrics.AspNetCore.Health.Core/Internal/Extensions/AppMetricsMiddlewareHealthChecksLoggerExtensions.cs
+++ b/src/App.Metrics.AspNetCore.Health.Core/Internal/Extensions/AppMetricsMiddlewareHealthChecksLoggerExtensions.cs
@@ -33,6 +33,14 @@ public static void MiddlewareExecuting<TMiddleware>(this ILogger logger)
             }
         }
 
+        public static void MiddlewareAuthorizationInvalid<TMiddleware>(this ILogger logger)
+        {
+          if (logger.IsEnabled(LogLevel.Trace))
+          {
+            logger.LogTrace(AppMetricsEventIds.Middleware.MiddlewareAuthorizationInvalidId, $"Invalid authorization App Metrics Health Middleware {typeof(TMiddleware).FullName}");
+          }
+        }
+
         private static class AppMetricsEventIds
         {
             public static class Middleware
@@ -40,6 +48,7 @@ public static class Middleware
                 public const int MiddlewareExecutedId = 1;
                 public const int MiddlewareExecutingId = 2;
                 public const int MiddlewareErrorId = 3;
+                public const int MiddlewareAuthorizationInvalidId = 4;
             }
         }
     }
diff --git a/src/App.Metrics.AspNetCore.Health.Endpoints/Builder/HealthApplicationBuilderExtensions.cs b/src/App.Metrics.AspNetCore.Health.Endpoints/Builder/HealthApplicationBuilderExtensions.cs
index b6f426c3..8d57d85a 100644
--- a/src/App.Metrics.AspNetCore.Health.Endpoints/Builder/HealthApplicationBuilderExtensions.cs
+++ b/src/App.Metrics.AspNetCore.Health.Endpoints/Builder/HealthApplicationBuilderExtensions.cs
@@ -3,6 +3,7 @@
 // </copyright>
 
 using System;
+using App.Metrics.AspNetCore.Health;
 using App.Metrics.AspNetCore.Health.Endpoints;
 using App.Metrics.AspNetCore.Health.Endpoints.Middleware;
 using App.Metrics.Health;
@@ -112,7 +113,8 @@ private static void UseHealthMiddleware(
                 appBuilder =>
                 {
                     var responseWriter = HealthAspNetCoreHealthEndpointsServiceCollectionExtensions.ResolveHealthResponseWriter(app.ApplicationServices, formatter);
-                    appBuilder.UseMiddleware<HealthCheckEndpointMiddleware>(responseWriter, endpointsOptionsAccessor.Value.Timeout);
+                    var healthAuthorizationFilter = app.ApplicationServices.GetService<IHealthAuthorizationFilter>() ?? new AuthorizedHealthAuthorizationFilter();
+                    appBuilder.UseMiddleware<HealthCheckEndpointMiddleware>(responseWriter, endpointsOptionsAccessor.Value.Timeout, healthAuthorizationFilter);
                 });
         }
     }
diff --git a/src/App.Metrics.AspNetCore.Health.Endpoints/Middleware/HealthCheckEndpointMiddleware.cs b/src/App.Metrics.AspNetCore.Health.Endpoints/Middleware/HealthCheckEndpointMiddleware.cs
index 46cc2f46..bde4cbf9 100644
--- a/src/App.Metrics.AspNetCore.Health.Endpoints/Middleware/HealthCheckEndpointMiddleware.cs
+++ b/src/App.Metrics.AspNetCore.Health.Endpoints/Middleware/HealthCheckEndpointMiddleware.cs
@@ -19,6 +19,7 @@ public class HealthCheckEndpointMiddleware
     {
         private readonly IRunHealthChecks _healthCheckRunner;
         private readonly IHealthResponseWriter _healthResponseWriter;
+        private readonly IHealthAuthorizationFilter _healthAuthorizationFilter;
         private readonly ILogger<HealthCheckEndpointMiddleware> _logger;
         private readonly TimeSpan _timeout;
 
@@ -28,12 +29,14 @@ public HealthCheckEndpointMiddleware(
             ILoggerFactory loggerFactory,
             IRunHealthChecks healthCheckRunner,
             IHealthResponseWriter healthResponseWriter,
+            IHealthAuthorizationFilter healthAuthorizationFilter,
             TimeSpan timeout)
             // ReSharper restore UnusedParameter.Local
         {
             _healthCheckRunner = healthCheckRunner;
             _logger = loggerFactory.CreateLogger<HealthCheckEndpointMiddleware>();
             _healthResponseWriter = healthResponseWriter ?? throw new ArgumentNullException(nameof(healthResponseWriter));
+            _healthAuthorizationFilter = healthAuthorizationFilter ?? new AuthorizedHealthAuthorizationFilter();
             _timeout = timeout <= TimeSpan.Zero ? TimeSpan.FromSeconds(20) : timeout;
         }
 
@@ -49,9 +52,18 @@ public async Task Invoke(HttpContext context)
             {
                 try
                 {
+                  if (!_healthAuthorizationFilter.Authorized(context))
+                  {
+                    _logger.MiddlewareAuthorizationInvalid<HealthCheckEndpointMiddleware>();
+                    context.Response.StatusCode = StatusCodes.Status401Unauthorized;
+                    await context.Response.WriteAsync("Invalid authorization.", cancellationToken: cancellationTokenSource.Token);
+                  }
+                  else
+                  {
                     var healthStatus = await _healthCheckRunner.ReadAsync(cancellationTokenSource.Token);
 
                     await _healthResponseWriter.WriteAsync(context, healthStatus, cancellationTokenSource.Token);
+                  }
                 }
                 catch (OperationCanceledException e)
                 {
diff --git a/test/App.Metrics.AspNetCore.Health.Integration.Facts/Middleware/HealthCheckEndpointAuthorizationMiddleware.cs b/test/App.Metrics.AspNetCore.Health.Integration.Facts/Middleware/HealthCheckEndpointAuthorizationMiddleware.cs
new file mode 100644
index 00000000..bbd8c59e
--- /dev/null
+++ b/test/App.Metrics.AspNetCore.Health.Integration.Facts/Middleware/HealthCheckEndpointAuthorizationMiddleware.cs
@@ -0,0 +1,31 @@
+// <copyright file="HealthCheckEndpointAuthorizationMiddleware.cs" company="Allan Hardy">
+// Copyright (c) Allan Hardy. All rights reserved.
+// </copyright>
+
+using System.Net;
+using System.Net.Http;
+using System.Threading.Tasks;
+using App.Metrics.AspNetCore.Health.Integration.Facts.Startup;
+using FluentAssertions;
+using Xunit;
+
+namespace App.Metrics.AspNetCore.Health.Integration.Facts.Middleware
+{
+  public class HealthCheckEndpointAuthorizationMiddleware : IClassFixture<StartupTestFixture<NotAuthorizedHealthTestStartup>>
+  {
+    public HealthCheckEndpointAuthorizationMiddleware(StartupTestFixture<NotAuthorizedHealthTestStartup> fixture)
+    {
+      Client = fixture.Client;
+    }
+
+    private HttpClient Client { get; }
+
+    [Fact]
+    public async Task Returns_correct_response_headers_not_authorized()
+    {
+      var result = await Client.GetAsync("/health");
+
+      result.StatusCode.Should().Be(HttpStatusCode.Unauthorized);
+    }
+  }
+}
\ No newline at end of file
diff --git a/test/App.Metrics.AspNetCore.Health.Integration.Facts/Startup/NotAuthorizedHealthTestStartup.cs b/test/App.Metrics.AspNetCore.Health.Integration.Facts/Startup/NotAuthorizedHealthTestStartup.cs
new file mode 100644
index 00000000..52c57013
--- /dev/null
+++ b/test/App.Metrics.AspNetCore.Health.Integration.Facts/Startup/NotAuthorizedHealthTestStartup.cs
@@ -0,0 +1,37 @@
+// <copyright file="NotAuthorizedHealthTestStartup.cs" company="Allan Hardy">
+// Copyright (c) Allan Hardy. All rights reserved.
+// </copyright>
+
+using App.Metrics.AspNetCore.Health.Endpoints;
+using App.Metrics.Health;
+using Microsoft.AspNetCore.Builder;
+using Microsoft.AspNetCore.Hosting;
+using Microsoft.Extensions.DependencyInjection;
+using Microsoft.Extensions.Logging;
+
+namespace App.Metrics.AspNetCore.Health.Integration.Facts.Startup
+{
+  // ReSharper disable ClassNeverInstantiated.Global
+  public class NotAuthorizedHealthTestStartup : TestStartup
+    // ReSharper restore ClassNeverInstantiated.Global
+  {
+    public void Configure(IApplicationBuilder app, IHostingEnvironment env, ILoggerFactory loggerFactory)
+    {
+      app.UseHealthEndpoint();
+
+      SetupAppBuilder(app, env, loggerFactory);
+    }
+
+    public void ConfigureServices(IServiceCollection services)
+    {
+      services.AddSingleton<IHealthAuthorizationFilter, NotAuthorizedHealthAuthorizationFilter>();
+
+      var appMetricsMiddlewareHealthCheckOptions = new HealthEndpointsOptions();
+
+      SetupServices(
+        services,
+        appMetricsMiddlewareHealthCheckOptions,
+        healthChecks: new[] { HealthCheckResult.Healthy() });
+    }
+  }
+}
\ No newline at end of file