Itzam Kʼan Ahk II left several monuments, including stelae at Piedras Negras and a large mortuary temple now known as Pyramid O-13.

[1] In 749 AD, the ajaw celebrated his one Kʼatun, an event that was attended by many dignitaries, including a bʼaah sajal ("first ruler") named Kʼan Moʼ Teʼ who had served Kʼinich Yoʼnal Ahk II.

(This panel has lent support to the argument that during Itzam Kʼan Ahk II's rule, Piedras Negras had eclipsed Yaxchilan in power.)

The Kʼatun celebration was followed by another event a few days later, at which Itzam Kʼan Ahk II "performed a 'descending macaw' dance" and then had a drink made from fermented cacao beans passed around to his guests.

[4] Itzam Kʼan Ahk II likely engaged in war, as a pyrite disc found in his tomb depicts the severed head of a leader from Hix Witz.

"[20] Stela 40 contains the depiction of the aforementioned woman dressed in Teotihuacano garb; it shows Itzam Kʼan Ahk II dispersing something—hypothesized to be either blood or incense—into a "psychoduct" (that is, "a vent leading into a subplaza tomb").

[24] Given that the last known rulers of Piedras Negras erected their stelae on or near this pyramid[24] and all three of these leaders also revered the site as some sort of dynastic shrine, it is possible that they were Kʼinich Yat Ahk II's sons.

[7] In 1997, Héctor Escobedo discovered a tomb (Burial 13) containing the bodies of an adult and two adolescents underneath the plaza floor at the front of the pyramid's frontal stairs.

[25] Among the artifacts found within (including pieces of jade and ornaments), archaeologists uncovered evidence that the tomb had been reentered after it was sealed: many bones were missing from the three bodies, and it appeared that the skeletons had been charred by fire sometime after their initial entombment.

Scholars eventually concluded that this apparent desecration was actually part of a ritual described on Panel 3 called el naah umukil (the "house-burning at the burial"), and that it was carried out by Kʼinich Yat Ahk II.