In Hindu culture, Kapalika means bearer of the skull-bowl, and has reference to Lord Bhairava's vow to take the kapala vow. As penance for cutting off one of the heads of Brahma, Lord Bhairava became an outcast and a beggar. In this guise, Bhairava frequents waste places and cremation grounds, wearing nothing but a garland of skulls and ash from the pyre, and unable to remove the skull of Brahma fastened to his hand. The skull hence becomes his begging-bowl, and the Kapalikas (as well as the Aghoris of Varanasi). supposedly use skulls as begging bowls and as drinking and eating vessels in imitation of Shiva. Although information on the Kapalikas is primarily to be gleaned from classical Sanskrit sources, where Kapalika ascetics are often depicted as depraved villains in drama, it appears that this group worshiped Lord Shiva in his extreme form, Bhairava, the ferocious. They are also often accused of having practiced ritual human sacrifices. Ujjain is alleged to have been a prominent center of this sect.

The Kapalikas may also have been related to the Kalamukhas ("black faces" or "face of time") of medieval South India. Moreover, in modern Tamilnadu, certain Shaivite cults associated with the goddess Ankalaparamecuvari, Irulappasami, and Sudalai Madan, are known to practice or have practiced ritual cannibalism, and to center their secretive rituals around an object known as a kapparai (Tamil "skull-bowl," derived from the Sanskrit kapala), a votive device garlanded with flowers and sometimes adorned with faces, which is understood to represent the begging-bowl of Lord Shiva