“On Sacred Ground” argues that the contentious representation of medicine people and religion in Native-authored fiction reveals the complex politics surrounding cultural and religious vitality in Native American communities. N. Scott Momaday writes in The Man Made of Words that “what most threatens the American Indian is sacrilege, the theft of the sacred”; he calls this a “subtle genocide” that deprives Native peoples of “spiritual nourishment.” Although aware that providing religious information in fiction is risky, all of the authors I discuss—Susan Power, James Welch, Sherman Alexie, Anna Lee Walters, Louis Owens, Leslie Marmon Silko and Louise Erdrich—include medicine people and ceremonies in their work and therefore must negotiate the ground between commercial success and tribal duty. These writers disagree about the role of the artist as a spokesperson for his/her people and about how to treat a mainstream, commercial reading audience. In the work of each writer, I argue, the representation of medicine people and ceremonial practices reveals divergent cultural values and political ideologies that ultimately affect cultural survival.