Recent debate has raised serious questions about the viability of the social and ideological reconstruction of prehistoric culture on the basis of mortuary analysis. In recent years bioarchaeology has gained considerable prominence, underscoring the fact that death, burials, and associated mortuary practices are multifaceted phenomena shaped by biological, social, ideological, and taphonomic factors. Few studies attempting social reconstruction through mortuary analysis, including those of a bioarchaeological character, have adequately addressed this multidimensionality. This study shows that social, ideological, and bioarchaeological reconstruction can be productively pursued through tight integration of a multitude of approaches and perspectives set within a long-term regional study. Focusing on two large 1,000-year-old Middle Sicán shaft tombs on the north coast of Peru, it integrates analyses of mitochondrial DNA, inherited dental traits, developmental health, diet, placement of interred individuals and associated grave goods, and data from ground-penetrating radar surveys. Overall it shows that these tombs reflected the broader social organization and were part of a planned elite cemetery and that the overlying monumental adobe mound served as the physical focus of ancestor worship.