The fruit can be eaten raw or cooked, and can be made into a syrup or preserves or jam. It has been used to make wine. The Mayo people made tortillas from the ground seeds mixed with some corn meal. This so-called etcho-seed flour was used in breakfast foods such as pancakes.

The Mayo used the cactus as an herbal remedy. Pieces of the flesh were applied to wounds to inhibit bleeding. The cactus flesh was cooked in salted water and the solution was applied to infected wounds three times daily, followed by a sulfathiazole powder. The juice was consumed as an herbal tonic and to treat sore throat.

The fruits used as combs by indigenous peoples. To make a hairbrush, the spines are removed from about two-thirds of the fruit, and the remaining spines were trimmed to about 1 cm in length.

There are 5 species of Pachycereus native to Central America and Mexico.

The genus, Pachycereus, comes from the ancient Greek παχύς (pachys) meaning "thick" and the Latin cereus meaning "torch".The specific name, pecten-aboriginum, is from the Latin, and means "native combs". It was inspired by the use of the fruits as hair combs.

This species is endemic to Mexico. Its range extends throughout the western states from Baja California through Sinaloa and Sonora to Chiapas. It grows in the Chihuahuan and Sonoran Deserts, the thorn forest of Sinaloa and Sonora, and the southern Sonoran plains. This is the most common columnar cactus in lower tropical deciduous forest of southern Sonora. In upper TDF it is largely replaced by Stenocereus montanus.