Bloodletting is a Mayan practice that dates back to ancient times and is still carried out today. It is used as a form of medicine, as a way of honoring the gods and sometimes as a punishment. Pieces of glass, rodent incisors and serpent teeth are the most common materials used in bloodletting instruments. The sharp point is hafted to a piece of wood, embedded in wax or, for more immediate use, simply held between the fingers. Today, beer bottle glass is often used because it makes a very sharp point when broken.The implements that are used for medical purposes are usually hafted to a piece of wood or held in the hand. Specific areas of the body are pierced in an attempt to relieve pain such as headaches, muscle aches and rheumatism. This treatment is sometimes done in the home, but for serious situations, there are more elaborate curing rites. In some cases, a ritual sweat bath accompanies the bloodletting ceremony. The steam from the bath stimulates the flow of blood and helps to lessen pain. The blood is sometimes collected in gourd bowls or on leaves and is examined by a curer to determine the nature of the illness afflicting the patient. The blood is also sometimes burned as an offering.

Another common bloodletting implement is called the ch'awil ch'ajan, which literally means 'waxed string'. This is a ball of wax, usually about 6 cm in diameter, in which shards of glass or other sharp objects are embedded. The ball is then attached to a rope or string. Often referred to as an autosacrifice ball, it is a self-flagellation device that is used to repent for past sins. A common punishment is three strikes across the back for minor sins and thirteen for more significant sins. Not all Maya used the ch'awil ch'ajan on themselves. Some groups used it as a type of punishment against other people.