For a long while, the controversy surrounding several bone tools coming from pre-Upper Palaeolithic contexts favoured the view of Homo sapiens as the only species of the genus Homo capable of modifying animal bones into specialised tools. However, evidence such as South African Early Stone Age modified bones, European Lower Palaeolithic flaked bone tools, along with Middle and Late Pleistocene bone retouchers, led to a re-evaluation of the conception of Homo sapiens as the exclusive manufacturer of specialised bone tools. The evidence presented herein include use wear and bone residues identified on two flint scrapers as well as a sawing mark on a fallow deer tibia, not associated with butchering activities. Dated to more than 300 kya, the evidence here presented is among the earliest related to tool-assisted bone working intended for non-dietary purposes, and contributes to the debate over the recognition of bone working as a much older behaviour than previously thought. The results of this study come from the application of a combined methodological approach, comprising use wear analysis, residue analysis, and taphonomy. This approach allowed for the retrieval of both direct and indirect evidence of tool-assisted bone working, at the Lower Palaeolithic site of Qesem Cave (Israel).