The term tropical ulcer, as applied to bone pathology, describes the specific pathologic phenomenon of the presence of a well-defined osteomatous shelf formation on the anteromedial aspect of the tibia. Despite the appellation ‘tropical,’ this pathology is not geographically limited to tropical regions, although it has not previously been reported from continental Europe. Observations of a 4583 BP burial from the Tanaro River area of Northern Italy represent the first such case. Dating of the site to the time of climate change at the end of the first Glacial suggests that hot–warm, humid conditions may have allowed the occurrence of this bone pathology, the first observed in continental Europe. A second explanation is the possible migration of an individual to Italy from an area that is more conventionally considered tropical. Copyright © 2013 John Wiley & Sons, Ltd.