In 1957, a new discovery inside Temple XVIII-A was made in Palenque, the Mayan archaeological site in Chiapas Mexico, a royal tomb of an original design which proved to be the oldest at the site. Two skeletons were found, the principal (PAL-44) was at the centre showing red pigmentation on the surface of some bones, personal adornments and offerings, which indicate that he was an early ruler of Palenque. The second (PAL-45), deposited at the entrance, not in a special mortuary position, without offerings, suggests it was of a lower social status. This research presents a new bioarchaeological analysis with the following results: (i) The result of a direct radiocarbon dating of PAL-44 by accelerator mass spectrometry is 250–420 cal AD (LTL12759A:1696 ± 30 BP). This means that the personage was buried long before the first designated ruler of Palenque, who, according to the epigraphic record was enthroned in ad 431. (ii) With X-Ray Fluorescence, the red pigment was identified as cinnabar (HgS). (iii) PAL-44 is a young adult male with a severe idiopathic scoliosis with a double curvature that affected the ribcage and lower limbs. Such a three-dimensional deformity resulted in changes to his body mechanics and induced motion asymmetry. Consequently, his health and mobility must have been significantly affected by such a severe condition. (iv) PAL-45 is an adult female with signs of nutritional problems in childhood and entheseal changes probably related to her activity. Three ante-mortem traumas are registered: rib fracture, frontal depressed circular fracture and a nasal septal deviation. This traumatic event took place two weeks, approximately, prior to PAL-45's death. Copyright © 2013 John Wiley & Sons, Ltd.