This chapter investigates chained metonymies, which are metonymies that involve multiple conceptual shifts. Drawing on a survey of body part terms in a large balanced sample of languages, it explores which types of conceptual shifts give rise to extended lexical meanings, and which types are involved in the development of more schematic, grammatical meaning. It is shown that for body part terms, chained metonymies mostly lead to lexical extensions, while serial extensions that are rooted in metaphor are cross-linguistically common in the development of grammatical meaning.