Uspanteko (Guatemala; ∼2000 speakers) is an endangered K’ichean-branch Mayan language. It is unique among the K’ichean languages in having innovated a system of contrastive pitch accent, which operates alongside a separate system of non-contrastive stress. The prosody of Uspanteko is of general typological interest, given the relative scarcity of ‘mixed’ languages employing both stress and lexical pitch. Drawing from a descriptive grammar and from our own fieldwork, we also document some intricate interactions between pitch accent and other aspects of the phonology (stress placement, vowel length, vowel quality, and two deletion processes). While pitch accent is closely tied to morphology, the location of lexical tone is entirely a matter of surface phonology. We propose that the position of pitch accent and stress is determined by three factors: (i) feet are always right-aligned, and preferably iambic; (ii) pitch accent must fall on a stressed syllable; and (iii) pitch accent cannot fall on a final mora. These assumptions derive default final stress, as well as a regular pattern of tone-triggered stress shift. Interactions between prosody and segmental phonotactics are attributed to further constraints on footing. Surprisingly, we find robust evidence for foot structure in Uspanteko, even though these patterns could easily be described in non-metrical terms. Interactions between tone and vowel length also provide evidence for lexical strata within the Uspanteko vocabulary.