The human head was a potent symbol for many South American cultures. Isolated heads were often included in mortuary contexts, representing captured enemies, revered persons, and symbolic “seeds.” At Salango, a ritual complex on the central coast of Ecuador, excavations revealed two burial mounds dated to approximately 100 BC. Among the 11 identified burials, two infants were interred with “helmets” made from the cranial vaults of other juveniles. The additional crania were placed around the heads of the primary burials, likely at the time of burial. All crania exhibited lesions associated with bodily stress. In this report, we present the only known evidence of using juvenile crania as mortuary headgear, either in South America or globally.