The Quina Mousterian is one of the well-defined Middle Paleolithic techno-complexes. Despite the pivotal research carried out in south-western France, the presence of this techno-complex across the rest of Europe is still poorly documented. Here we apply a techno-functional approach, combining technological and use-wear analyses, for reconstructing lithic core-reduction, tool-reduction, and tool use at De Nadale Cave, a single-layered Mousterian site with Quina features located in northern Italy and dated to the early MIS 4. Our results indicate that the flexible core reduction strategies identified at De Nadale show some similarities with the Quina knapping method, in addition to the adoption of centripetal methods on single surfaces. Variations of this scheme identified at De Nadale are the exploitation of lateral and narrow fronts which are aimed to the production of elongated, small blanks. A parallel, ramified reduction is applied to limace cores and Quina or demi-Quina scrapers having diversified purpose (mixed matrix). These blanks are exploited as tools and cores-on-flakes from which thinner, usable flakes or bladelets are detached. The use-wear identified on both scrapers and reaffutage flakes further confirm this behavior, demonstrating the use of both tools, albeit for different tasks (i.e., scraping and cutting). We discuss the ecological implications of this behavior within the Quina Mousterian. The high frequency of retouched tools and Quina or demi-Quina scrapers seems to accompany the highly mobile human groups associated with this techno complex and their seasonally organized subsistence strategies. Finally, by combining available multidisciplinary data on paleoenvironment, subsistence, and chronology, we were able to embed the neanderthal settlement of De Nadale in a regional and Western European frame, underlining the importance of the Quina Mousterian in Western Eurasia between MIS 4 and early MIS 3.