Entheseal changes are distinct skeletal markings that occur where a muscle, tendon, or ligament inserts into bone cortex, in response to many factors including physical activity. Therefore, entheseal changes have been frequently used to reconstruct habitual life activities of ancient populations. The present study examines a sample of 195 ancient Egyptians from Giza—Old Kingdom (2700–2190 BC), the period of pyramid builders. The material consists of two burials that were identified as belonging to individuals of different socio‐economic classes: workers and high officials. This distinction between the socio‐economic classes is based on evidence including location and design of cemeteries, contents of goods, and writings and drawings on tombs. Entheseal changes at 14 sites, representing the main articulations of the body, were examined to assess any association between entheseal expression and physical activities. The results of this study suggest that the frequency and severity of entheseal changes varied between workers and high officials, and between males and females. As expected, males exhibited higher levels of entheseal expression, suggesting sexual dimorphism in activity. No clear bilateral asymmetry was observed, except for in female high officials, who exhibited higher levels of entheseal expression at the right hand. A direct comparison of frequencies of entheseal changes between the two social classes, by sex and age, revealed that male and female workers had higher levels of entheseal expression than high officials, suggesting a division in labour. Together, these data suggest that entheseal changes can be used, cautiously, to study activity patterns in ancient Egyptian populations.