His statues and stone masks always showed him wearing a freshly flayed skin (his name means Our Lord the Flayed One).

Aztecs adopted Xipe as a god during the reign of Emperor Axayacatl (1469-81).

During the second ritual month of the Aztec year, Tlacaxipehualiztli (Flaying of Men), the priests killed human victims by removing their hearts. They flayed the bodies and put on the skins, which were dyed yellow and called teocuitlaquemitl ("golden clothes"). Other victims were fastened to a frame and put to death by arrows; their blood dripping down was believed to symbolize the fertile spring rains.

A hymn sung in honour of Xipe Totec called him Yoalli Tlauana (Night Drinker) because good rains fell during the night; it thanked him for bringing the Feathered Serpent, symbol of plenty, and for preventing drought.