Held by Wrathful Deities, and by the Living Practitioners of Chod

The kapala appears constantly in Tibetan Buddhist iconography as an attribute held by wrathful and semi wrathful deities, who are depicted carrying it as one of several symbolic implements marking their specific role and power within the tantric pantheon, and it is closely associated with chod, a specific meditative practice in which the practitioner ritually visualises offering their own body as food to demons and hungry spirits, a practice for which the kapala's imagery of transformed, offered substance is directly thematically relevant.

As with the phurba, the deeper liturgical and meditative use of the kapala belongs to initiated tantric practice that requires appropriate training and, in many lineages, formal empowerment, so this entry describes the object's general form and symbolic association rather than any specific ritual procedure. Beer's scholarship documents real historical and regional variation in how strictly the tradition of using an actual human cranium was maintained, and contemporary practice across the great majority of Tibetan Buddhist communities today relies on metal or other substitute materials rather than human remains, a shift Beer treats as long established rather than a recent accommodation to modern sensibility alone.