Evidence of cranial surgery, in the form of trepanations, has been found at prehistoric archaeological sites from all over the world. Within this large body of evidence, it is clear that trepanations vary in size, location and the reason for which they were performed. Numerous trepanations have been discovered at archaeological sites across China, but very few have come from Qijia Culture (2300-1500 BCE) sites in Northwest China. This research describes a well-healed trepanation on an adult male individual [M179:R2] from the Mogou site and compares it to contemporaneous examples from China that date from 3000 BCE-0 CE in order to elucidate how and why this procedure was performed. A small circular opening with slightly irregular, but well-healed, margins was identified on the left parietal bone, immediately posterior to the coronal suture. The characteristics of the lesion suggest that the scraping method was employed to create the opening. Unfortunately, the advanced stage of healing made the identification of the specific instrument used in the trepanation impossible. The characteristics of the incision and the archaeological context led the authors to propose that the trepanation on M179:R2 was performed as part of a magico-ritual, rather than for a non-ritual medical purpose. This is supported by the presence of multiple individuals, mainly men, from the Mogou site with similar well-healed trepanations