There is a practice of performing Muthappan Anthithira only once in all muthappan temples. Its performance needed lot of money. On 6 January 2008 Muthappan Anthithira was performed in the Nileshwar Muthappan Madappura. The theyyam looks like muthappan in the back and vairajathan in the front. But it symbolises the God Shiva and Vishnu. Thousands of people attended the festival and food was served to around one lakh people as prasadam on that occasion.