Solid state lighting (“SSL”) devices with improved current spreading and light extraction and associated methods are disclosed herein. In one embodiment, an SSL device includes a solid state emitter (“SSE”) that has a first semiconductor material, a second semiconductor material spaced apart from the first semiconductor material, and an active region between the first and second semiconductor materials. The SSL device can further include a first contact on the first semiconductor material and a second contact on the second semiconductor material and opposite the first contact. The second contact can include one or more interconnected fingers. Additionally, the SSL device can include an insulative feature extending from the first contact at least partially into the first semiconductor material. The insulative feature can be substantially aligned with the second contact.