This chapter analyzes the interpretation of Andean paleopathology on disability, revealing how ableist medical discourse has dominated archaeology and reinforced colonial views. From an anti-ableist position, we propose a critical rereading, urging consideration of other possible relationships between disabilities in pre-Hispanic societies. Thus, we propose an essay with reflections and questions about the huaco portraits and Felipe Guaman Poma de Ayala’s Primer Nueva crónica y buen gobierno (First New Chronicle and Good Government), with its references to disability during the period in which Tawantinsuyu was conquered, to allude to the coloniality of ability.