Used to hold up the skirt, a backstrap woven belt is an indispensable element of indigenous female costume. Belts are manufactured in various lengths and widths and may be simple, as that of Almolonga, or decorated with brocaded or embroidered designs as those worn in San Juan and San Pedro Sacatepéquez. Most belts, as that of San Juan Ostuncalco, are simply wrapped several times about the waist, with the ends tucked in; others, as in Colotenango, are tied on, with the ends hanging loose. Most belts have ends that are simply fringed, braided, or corded; a notable exception is that of Santiago Sacatepéquez, which is finished with long cords terminating in doughnut shaped pompons in bright colors.

While some women weave their own belts, in a style specific to their town, many others purchase their belts from professional weavers. In Chichicastenango, for example, men both weave and embroider women's belts. In many towns, a woman will wear a belt of non-local manufacture, most often a stiff, narrow band with alternating black and white warps woven in Totonicapán. These belts are adorned with numerous registers of tiny figures: birds, women with water jars, hands, animals, even buses. Weavers often incorporate their name into a register. One half of the belt will often be adorned in bright colors with the other half executed in more sombre tones. The success of the Totonicapán belt is evidenced by the fact that its design has remained virtually unchanged for at least a century.

While women's belts usually differ in design and materials from the man's sash, in a few villages they are the same or only slightly different. In Sololá, for instance, a certain style of belt will be worn by either men or women, although men will wear it under their rodillera. The woman's belt of Nahualá, on the other hand, varies only slightly, in number of registers and design motifs, from that worn by men.