Devotees worship Qingshui Zushi with offerings of fruits, incense, and the Three Sacrificial Animals. As a deity associated with rain and disaster prevention, farmers have historically prayed to him during droughts. A unique feature of worship is observing the "Nose-dropping Warning" — checking whether the statue's nose has cracked or fallen, which is believed to predict earthquakes, typhoons, or other disasters. Sanxia Zushi Temple, rebuilt over decades by master artist Li Mei-shu using only traditional methods and hand-carved stone pillars, is itself an act of worship through art.