At the turn of the twenty-first century, renewed globalattention to sacred sites has underscored their pivotal role in cultural memory,spirituality, and identity formation. In Latin America, these sites areembedded within complex biocultural landscapes where tangible and intangibleheritage converge through ritual, oral tradition, and ecological stewardship.Venerated for their spiritual meanings—rooted in Indigenous, Afro-descendant,and syncretic worldviews—they are also sites of resistance, culturalresilience, and political mobilization. Despite their recognized value, sacredsites increasingly face threats from unregulated tourism, extractive industries,urban encroachment, climate change, and the weakening of intergenerationaltransmission. In some cases, spiritual meanings are commodified or sidelined byheritage frameworks that privilege monumental or aesthetic criteria over livedsacredness. This article offers a critical and interdisciplinary approach tosacred heritage in Latin America, examining tensions between global heritageregimes and local cosmologies. Through emblematic case studies, including LakeTiticaca (Bolivia–Peru), the Sierra Nevada de Santa Marta (Colombia), andIndigenous territories in the Amazon and Mesoamerica, it explores howpatrimonialization can either erode or revitalize spiritual meaning. Finally,it proposes pathways for more inclusive, respectful, and multidimensionalgovernance of sacred sites, aligned with community values, rights-basedapproaches, and the evolving normative landscape of UNESCO.