头骨变形是一种具有广泛时空分布的古老文化习俗，可能与身份等级标记、美学、宗教等多方面有关，同时也是古代社会育婴行为的结果。中国史前人类的头骨变形线索最早见于旧石器时代，在新石器时代以后发展为普遍的文化习俗，存在额枕-环状变形和枕部变形两个本地起源的体系。额枕-环状变形发源于东北北部地区，具有强烈的外观展示性，所需技术复杂，是中国乃至世界范围内最早出现的有意识头骨变形习俗之一，并可延续至历史时期；其起源可能与东北地区独特的资源地理环境以及旧、新石器时代过渡阶段采集渔猎社会复杂性的发展，如性别分工、等级分化等存在关联。枕部变形的地理分布以黄河流域为中心，其对外观改造较弱，技术相对简单，在新石器时代晚期至末期普遍流行；最初出现可能与北方农业社会的育婴实践有关，并逐渐演变为文化习俗。枕部变形在新石器时代末期开始衰落并在青铜时代以后基本消失，这一过程应与新石器时代晚期以来的文化发展历程，尤其是中国新石器末期传统文化核心区衰落的史前文化格局重大变革有关。

The ancient cultural practice of cranial modification is widely distributed throughout the world. It has a highly symbolic visual feature and is related to various societal aspects such as hierarchy, status, aesthetics and religion. Cranial modification can also be considered a result of infant-rearing behaviors in ancient times. The earliest clue to cranial modification in China came from the Paleolithic, but it was not until the Neolithic that it became a widespread cultural practice later flourishing. Cranial modification in prehistoric China is classified into tabular-annular modification system and occipital modification system. Both originating locally, these two systems have different appearances, distributional ranges, and developmental processes. Tabular-annular modification, originated in northern Northeast China, exhibits prominent cosmetic features and requires complex technology. It is considered to be the earliest known conscious cranial modification practice and may have continued into the historic period. The origin of this tabular-annular modification may be correlated with unique geographic and environmental resources of Northeast China along with a growing complexity of gathering-fishing-hunting society, a gender division of labor, and the hierarchical differentiation existent in a transitional phase from Paleolithic to Neolithic. Occipital modification, centered in the Yellow River basin, is characterized with less pronounced modifications and probably required simpler techniques. It was once widely popular in the late and final Neolithic. Occipital modification may derive from behaviors of infant-rearing in northern agricultural societies and gradually evolved into a conscious cultural practice. Its decline at the end of the Neolithic and eventual disappearance after the Bronze Age was closely connected to societal changes occurring during the Late Neolithic, especially in the Longshan-Erlitou cultures. Both tabular-annular and occipital modification systems vary in skull morphology and measurement data suggesting that modification tools, techniques, and procedures were diverse. Existing studies on cranial modification are dominated by qualitative descriptions, with detailed observation and more systematic measurements necessary for future studies, as well as more refined archaeological contextual information.