In imperial Chinese protocol, the kowtow was performed before the emperor. Current Chinese etiquette does not contain any situations in which the kowtow is performed in front of a living human being, although the kowtow is often performed in groups of three before Buddhist statues and images or tombs of the dead.
Kowtow came into English in the early 19th century to describe the bow itself, but its meaning soon shifted to describe any slavish support or grovelling.
See also: Chinese social relations