Anatomical votives were deposited by offerants in pre-Roman Italy from the seventh century until roughly the first half of the first century BCE. The most vital ideation phase—at least of the prototype, from which molds that were used for multiple decades and generations were derived—coincides with the proto-Hellenistic phase. The period was distinguished by a close relationship between craftsmanship and the most refined figurative manifestations in a central Italic culture characterized by an increasingly strong koine. A variety of body parts were depicted, from whole and half heads to external body parts and internal organs. The votives are found at sanctuaries throughout the Etrusco-Italic region. Dedicatory inscriptions are scarce, so the meaning of these anatomical votives is debated. This chapter examines how the practice changed over time and explores the reasons for its decline.