The Mid Upper Paleolithic Sunghir 1 burial of an older adult male is one of the most elaborate burials known, with red ochre, thousands of mammoth ivory beads, and other body ornaments. Reanalysis and cleaning of the skeletal remains revealed a perimortem incision in the ventral–lateral first thoracic vertebra (T1) body, most likely from a sharp blade or point and the probable cause of death. Context indicates that the trauma was most likely from a hunting accident or social altercation. The unusual cause of death may be correlated with the exceptional burial elaboration of Sunghir 1, adding to the high frequency of unusual individuals in the ‘red ochre’ burials of the Mid Upper Paleolithic. Copyright © 2010 John Wiley & Sons, Ltd.