**Background:** Since the 1970s, monumental stone structures called mustatil have been documented across Saudi Arabia, but their function remained unknown until recent excavations. This paper presents the results of excavations at site IDIHA-0008222, a 140 m long mustatil (IDIHA-F-0011081) located 55 km east of AlUla, conducted by the University of Western Australia's AAKSA project. The study aimed to understand the function of these structures and their role in Late Neolithic society.
**Methods:** The site was identified through remote sensing and aerial photography, then excavated using single-context recording. All sediment was sieved through 2 mm or 5 mm mesh with 100% collection. Faunal remains were identified using comparative osteological datasets and specialized literature. Radiocarbon dating was performed on 11 samples (bone, charcoal, horn, tooth dentine) at the Australian National University and University of Georgia, with results calibrated using OxCal v4.4.4 and IntCal20. Human remains were analyzed by a forensic anthropologist for minimum number of individuals (MNI), sex, age, and pathology.
**Key Results:** The mustatil head contained two chambers; the main chamber (3.10 x 2.80 x 2.5 x 2.85 m) held three upright stones (betyls), with stone A (0.8 x 0.43 x 0.1 m) as the primary focus. Four phases of activity were identified (Phases 1–4), with faunal deposits concentrated around stone A. A total of 247 faunal remains (NISP) were recovered, weighing 3,201.9 g. The assemblage comprised 89 remains of domestic cattle (Bos taurus), 128 remains of Bos sp., 5 remains of domestic goat (Capra hircus), 19 undetermined caprines, 1 gazelle (Gazella sp.), and 5 small ruminants. All remains were cranial elements (horns, horn sheaths, maxillary teeth, cranial fragments); no post-cranial bones were present. Horn measurements indicated adult males predominated: four cattle specimens (#0033, #0037, #0039, #0043) had basal circumferences of 210–240 mm and maximum diameters 70–86.6 mm, fitting male ranges. Goat horns (#0036-#0041, #0042, #N01) were also male. MNI was 8 cattle (2 sub-adults ~2.5 years, 1 young adult 3–4 years, 2 adults 4–9 years, 3 adults >9 years) and 3 goats (1 adult, 1 sub-adult, 1 adult/sub-adult). Anthropic marks included cut marks on a cattle molar (#0056) and a chop mark on cattle horn (#0033). Radiocarbon dates from the mustatil clustered around 5000 BC, with modelled ranges: Phase 1 (5296–5052 cal BC to 5026–4848 cal BC), Phase 3 (5209–4944 cal BC to 4846–4173 cal BC), Phase 4 (5306–4994 cal BC to 5208–5210 cal BC). A cist (IDIHA-F-0011213) north of the mustatil contained a single adult male (SK003) aged 30–40+ years, with evidence of osteoarthritis and Schmorl's nodes, dated to 4673–4461 cal BC. A stone-lined hearth (IDIHA-F-0011091) was dated to 4717–4553 cal BC.
**Clinical Implications:** This study is archaeological and has no direct clinical implications. However, the analysis of human remains provides insights into the health and lifestyle of Neolithic individuals, including evidence of degenerative joint disease (osteoarthritis) and spinal pathology (Schmorl's nodes), which are relevant to understanding the history of musculoskeletal conditions in ancient populations.