This paper analyzes the roles and attributes of the Maya goddess Ix Hun Ahau, the female manifestation of Hun Ahau that appears in the Ritual of the Bacabs. This Colonial Yucatec text is our earliest surviving source for how Maya cosmology provided a framework for healing practices. Although the extant manuscript dates to the late eighteenth century, it is the culmination of centuries of interethnic interaction, including innovations emerging from the intellectual exchange that characterized Mesoamerica during the Late Postclassic period (ca. A.D. 1200–1500). The accoutrements and activities ascribed to this goddess in the incantations identify her as a Maya parallel to Tlazolteotl-Ixcuina, the Nahua goddess of weaving, sexuality, pollution, and its purification. Pollution concepts and purification practices that are otherwise peripheral in the Ritual of the Bacabs are specifically related to Ix Hun Ahau, suggesting that early intellectual exchange between Mesoamerican peoples extended to medical cosmologies as well.