With a history of use stretching back at least 2,000 years (Rätsch, 2005), E. pachanoi is employed in modern curanderismo as a medicament and entheogen (Sharon, 1972; Schultes et al., 2001). Also referred to as Cardo, Huachuma, or Huando Hermoso, this species cacti is applied by Andean folk healers to treat dermis-bound infections and as a diuretic (Sharon, 1972). Additional uses of E. pachanoi include ritualistic administration as an entheogen and limited use as an aphrodisiac (Rätsch, 2005). According to Schultes (1970), E. pachanoi is often employed by Peruvian folk healers in the form of a liquid concoction containing other plants, such as Datura. Refered to as cimora, the concoction in question is typically prepared by boiling slices of small cactus sections for several hours, during which other botanical ingredients are often added (Schultes et al., 2001).

Easily cultivated via seed propagation and even easier via cuttings or cloning, E. pachanoi and related species are common ornamentals favored by garden enthusiasts throughout the world (Trout, 2005). Yielding large, white flowers and growing up to six meters in height, E. pachanoi is variable in rib count, commonly manifesting with six ribs. However, some variants may develop as little as four or as many as twelve ribs (Rätsch, 2005; Trout, 2005). According to Trout (2005), four-ribbed specimens are rare and tend to produce additional ribs with growth. Additionally, the expression of spines is also variable. Spines may commonly be seen at lengths up to 2 cm, though they can be notably smaller or even absent in some cases (Trout, 2005). According to Trout (2005), both wild and seed-grown varieties are generally "spinier" than commonly cultivated cloned specimens, though some wild Peruvian variants often express spines of a smaller disposition. 

The flowers produced by E. pachanoi are nocturnal bloomers, remaining closed during the daytime before presenting their remarkable aesthetics in the evening (Schultes et al., 2001; Rätsch, 2005). Thus, pollination is carried out via nocturnal insects and other small animals such as bats (Shetty et al., 2011). According to Trout (2005), the flowers generally open around 7 pm, closing around 10 am. Additionally, the flowers produced by E. pachanoi yield large red fruits (Rätsch, 2005; Shetty et al., 2011). Described by Rätsch (2005) as pleasant to the gustatory senses, the fruit produced by E. pachanoi provides a nutritional resource to various species, such as Tremarctos ornatus, which feeds upon the fruits in March and November (Peyton, 1980).

Similar in its phytochemistry to peyote (Lophophora williamsii) the primary active chemical constituent of E. pachanoi is that of mescaline, which has been found to approximate up to 2% of the cacti’s dried phytomaterial (Schultes, 1970; Trout, 2005; Schultes et al., 2001). However, mescaline concentrations in dried E. pachanoi samples have been recorded at concentrations up to 4.7% of the dried plant material (Ogunbodede et al., 2010). Though mescaline is found in other cacti species, concentrations are often low, rendering both E. pachanoi and L. williamsii as the only extensively used mescaline containing cacti (Cassels & Sáez-Briones, 2018). However, it should be noted that closely related species, such as E. peruvianus and E. bridgesii, are often employed in replacement of E. pachanoi (Trout, 2005).