Neanderthals and anatomically modern humans (AMHs) may have lived in close proximity in the Near East region during Middle Paleolithic times. Although functional morphological analyses suggest a marked behavioral contrast between these two human groups, new dental micro- and macro-wear studies, together with new archaeological data, have revealed some similarities in ecology and dietary habits. In this study, we analyze the tooth wear patterns of Neanderthals and AMH from Middle Paleolithic sites of Israel and Northern Iraq, using the Occlusal Fingerprint Analysis (OFA) method to virtually reconstruct the jaw movements responsible for the creation of the occlusal wear areas. We particularly focus on para-facets, a distinctive type of wear which has been previously described in the dentition of historic and modern hunter-gatherers. The analysis reveals a similarity in para-facet frequency between early Near Eastern Neanderthals and AMH, and a significant difference with other Pleistocene human groups. The absence of antagonist occlusal contacts in the lower teeth and the occlusal compass analysis suggest that para-facet formation is not related to normal mastication but to nonmasticatory activities. Thus, the identification of these nonmasticatory wear areas on the molars of early Near Eastern Neanderthals and AMH may indicate analogous tooth-tool uses for daily task activities. These may have emerged independently or could be interpreted as indirect evidence of cultural interactions between these two groups. Am J Phys Anthropol 152:107–117, 2013. © 2013 Wiley Periodicals, Inc.