This chapter examines changing practices of human sacrifice at the Huaca Pucllana platform pyramid in Lima, Peru. The construction of the pyramid was initiated by the Lima culture around 400 AD, and, as the Lima culture settled over the next four centuries, numerous individuals were sacrificed and buried in the foundations of the newly erected platforms. The individuals were often young women, who were either stabbed in the chest or had received strong blows to the head. The Waris occupied the area from around 800 AD and used the pyramid mainly as a cemetery. Infants may, however, have been sacrificed to follow individuals of the Wari elite in their deaths. In the final occupational phase of the pyramid, during the Ychsma culture, human sacrifices were no longer performed but were replaced by ritual offering and destruction of large, curvy ceramics symbolising women. This chapter further examines ritual sacrifices at Huaca Pucllana in relation to coastal natural disasters.