Pag-ipat (ritual against disease) is a traditional healing ritual of the Maguindanaon people in the southern Philippines. Devoid of Islamic components, it is based on numerous ideas such as possession, invisible spirits, mythological history, and the offering of sacrifice. This study explores the signs and symbols incorporated in pag-ipat. Through a multimodal semiotic analysis, specifically ethnographic observation, this research determines the meanings conveyed by the semiotic resources used, expounds on how semiotic resources are orchestrated to communicate meaning, and rationalises the ideology expressed in the ritual performance. Findings reveal that the resources utilised in the performance of pag-ipat communicate gratitude and love, recognition, honour, appreciation, journey, generosity, kindness, recognition of their ancestor, invitation to the neighbours and the community, healing, enlightenment, freedom from darkness, identity marker, greediness, and life. Through the manner of installing the pandala (flags), the presence of the sambulayang (set of flags), the quantity of food, the quality of the cloth, the number of days spent in the ritual, the design of the food and clothing material, the dance movement of the medium, and the kulintang music produced by the performers, the healing rite manifests social standing and artistic skill of the performers. The practise of pag-ipat tells us that regardless of Maguindanaon’s observance of Islam as official religion, some believe in the existence of ancestral spirits, mythological entities, and spirit animals, which has a significant impact on their beliefs and behaviour. Thus, ritual elements increase signification and meaning-making potentials in the discourse environment because of their iconicity, indexicality, and meaning-making potentiality.