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Tattooing has become a prominent form of body modification worldwide since the 20th century, leading to a revival of traditional hand-tap techniques, especially those from Samoa. The Samoan traditional pe’a (male tattoo) and malu (female) are distinctive, as they are administered by hand-tap tools in open-air bungalows and are to be completed in a short period of time, usually 1-2 days for the malu and a week to a month for the pe’a. This study involved systematically collecting saliva samples from participants undergoing traditional Samoan tattooing practices facilitated by Sulu’ape Tatau in Apia, Samoa. The Sulu’ape Tatau lineage is recognized as a prominent representative of the Su’a Guild, which holds significant cultural and historical importance within the realm of Samoan tatau. This study characterizes the physiological responses to tatau by analyzing biomarkers such as cortisol, secretory immunoglobulin A, and C-reactive protein. Given the constraints on healthcare resources in Samoa, understanding these physiological responses provides insight into how cultural practices like tatau may enhance biological resilience against health challenges.