The beaded burial is almost universally interpreted as the interment of an individual of extraordinary status — a leader or religious figure of the highest rank, buried with lavish expenditure of valuable materials.

Surrounding and in some cases beneath the beaded burial were other burials — groups of young women, in one case approximately 50 individuals, whose physical condition at death and the circumstances of their deposition suggest sacrifice rather than natural death.

The interpretation of these burials as sacrificial is not universally accepted, and the forensic evidence has been subject to continuing analysis and debate.

But the preponderance of the archaeological interpretation supports a reading in which the mortuary ceremonies associated with high-status burials at Cahokia involved the death of other people — a practice documented ethnographically in various cultures around the world, particularly in societies with highly developed political hierarchies.