Lieu Hanh stands within Dao Mau's Four Palace, Tu Phu, cosmological system as the presiding goddess overseeing a large pantheon of subordinate mother goddesses and spirits associated with the sky, water, mountains and forest, earth, and this system is given living ritual expression through len dong, a spirit possession ceremony in which a medium, generally understood as female or embodying a female role regardless of the medium's own gender, is possessed in sequence by a series of these deities, each manifestation marked by a change of costume, music, dance and behaviour specific to the spirit currently present.
UNESCO inscribed the "practices related to the Viet beliefs in the Mother Goddesses of Three Realms" on its Representative List of the Intangible Cultural Heritage of Humanity in 2016, formal recognition of Dao Mau's living, actively practised status in contemporary Vietnam. Taylor's scholarship notes that Dao Mau and Lieu Hanh's cult experienced significant growth following Vietnam's post-reform economic liberalisation, becoming one of the clearest examples of a genuinely indigenous Vietnamese religious tradition expanding rather than declining under modern conditions.