This paper presents internal and comparative evidence showing that the origin of the accentual contrast of modern Terena, an Arawakan language of southwestern Brazil, is related to a diachronic process of word-initial vowel loss. Alternations internal to the language involve a relation between vowel-initial trisyllabic allomorphs and consonantinitial disyllabic allomorphs, the latter bearing a tonal accent. Comparative evidence from Mojeño, one of Terena's closest relatives, provides crucial support for the correspondence between word-initial vowels and an initial tonal accent. A coherent account is proposed, tracing both the loss of initial syllables and the emergence of an accentual contrast to sub-phonemic patterns enforcing durational unevenness in iambic feet: syllables in foot-internal, non-head position were lost, while the previously allophonic lengthening of the head syllable was phonologized, yielding the tonally marked accent.