Trepanation is a long-lasting ancient practice found around the world with diverse motivations. However, the distribution and motivation of intentional trepanation in China remain unclear. This study presents one of the earliest trepanations on a male adult individual who is unearthed from the Shuanghuaishu site in Gongyi, Henan, dating back to the late Yangshao cultural period (3500–2900 BC). The macroscopic and microscopic o...