There are tens of thousands of painted rock art motifs in the Serranía de la Lindosa in the Colombian Amazon, including humans, animals, therianthropes, geometrics, and flora. For most of the last 100 years, inaccessibility and political unrest has limited research activities in the region. In this paper, we discuss findings from six years of field research and consider the role of rock art as a manifestation of Indigenous ontologies. By employing intertwining strands of evidence—a range of ethnographic sources, local Indigenous testimonies from 2021–2023, and the motifs themselves—we argue that the rock art here is connected to ritual specialists negotiating spiritual realms, somatic transformation, and the interdigitation of human and non-human worlds.