There exists an elaborate ritualistic ceremony called Pampinthullal (serpent dance) conducted for propitiating the serpent gods. This ceremony takes place during the Malayalam months of Kanni, Thulam, Kumbham and Medam. The Ayilyam (the Aslesha star) on which falls the birthday of serpents is held auspicious for the serpent dance ceremony. The monsoon months are avoided for the ceremony since the serpents would refuse to come out of their subterranean abodes during this season.

Pampinthullal is conducted in the temporary sheds attached to the serpent grove or constructed in front of the courtyard of the house. A thatched shed with its floor plastered with cow dung and elaborate floral decorations around is made. Kalams of the serpent gods are drawn on the floor using powders of different colours. Bronze oil lamps are lighted in the Kalam with offerings of coconut and rice placed before the lamp. Pampinthullal is made to propitiate all five varieties of serpent gods - Nagaraja (the king serpent), Nagayakshi (the queen serpent), Karinagam (black serpent), Paranagam (flying serpent) and the Anchilamaninagam (five-hooded and jewel-carrying serpent). Pampinthullal usually lasts for five days, with one of the varieties propitiated on each day. The process of the ritual starts with the whole village participating in the festivities, the Mannan plucking the flower, bunches from the areca and the veluthedan (washer man) bringing the mattu (washed clothes). The Pulluvan is the chief priest who officiates at the ceremony and sings about the serpents in chorus to the accompaniment of instruments played by males and females. The ceremony starts in the morning with songs in praise of Ganapathy at the place where the Kalam is to be made. By noon the images of serpents would have been completed on the floor. The musical score in front of the Kalam ensues when the Paniyal (the representative of the family on whom the effects of the rituals are concentrated) is seated. There may be more than one Paniyal known as 'Kappum Kanyavum' (one boy and one girl) sitting, each with a petal of the areca flower as recipients of the blessings of the serpents. They get possessed and dance with the flower in hand to the accompaniment of the music of the Pullavas, the tempo of which goes in arithmetical progression, reaching the maximum pace. The Paniyal enters the Kalam and rubs the figure of the nagas with the flower bunch. In case the Paniyal does not get possessed or in fury, tries to destroy the decorations, the devotees take it as an indication that the rituals have not brought the desired result. The whole ceremony will then have to be repeated.