Artificial cranial deformation is a recognized attribute of many archaeologically recovered Andean skeletal collections. Ethnohistoric sources document the diversity of forms used to mark both vertical and horizontal status distinctions among Late Horizon peoples. Region-specific social groups were characterized by distinctive deformation styles, as were individuals of Inka heritage. Review of early Spanish accounts and consideration of various strategies commonly used in analyzing deformation forms suggest that investigators be sensitive to both final skull shape and the nature of deforming devices. This case study maintains that detailed descriptions of skull form will permit interpretations of technique and apparatus used, without the actual deforming artifacts. We examined archaeologically recovered skeletal remains from Huaracane-phase, Tiwanaku-related Chen Chen-phase (Tiwanaku V), and Tumilaca-phase cemetery components of the Omo site group, located near the present-day town of Moquegua in southern Peru. Our analysis demonstrates that the pattern of cranial deformation within the Omo M10 cemetery complex clearly emphasizes homogeneity within individual cemeteries and heterogeneity across cemeteries. We enlist current competing models for Tiwanaku hegemony to interpret this pattern.