Forensic scientists sometimes apply knowledge and modern techniques to various historical challenges. Reported here is an unusual expertise of a shrunken head authenticity evaluation. Tsantsas, or shrunken head, are an ancient traditional technique of the Jivaro Indians from Northern Peru and Southern Ecuador. Tsantsas were made from enemies’ heads cut on the battlefield. Then, during spiritual ceremonies, enemies’ heads were carefully reduced through boiling and heating, in the attempt to lock the enemy's spirit and protect the killers from spiritual revenge. However, forgers have made fake tsantsas out of sloth heads, selling them as curios to international travelers. Morphologic criteria can help in the distinction of forged and authentic tsantsas. Presence of sealed eyelids, pierced lips with strings sealing the mouth, shiny black skin, a posterior sewn incision, long glossy black hair, and lateral head compression are characteristic of authentic tsantsas. On the other hand, fake tsantsas usually present few or none of those criteria. To establish authenticity of the shrunken head, we used all of the above-mentioned morphologic criteria along with microscopic hair examination and DNA analysis.