Located 3,886 m above sea-level, Achanchi, built in the 10th-12th century, AD, is one of the largest Chanka sites in the highland region of Andahuaylas, Peru and host to more than 300 stone buildings on over 15 ha. But what was the site used for? Two possibilities exist: 1) as a peaceful, integrative agro-settlement, or 2) as a defensive hill fort. Examining the health of those buried at Achanchi may help address these hypotheses