This chapter considers whether cave burial in Britain starts in the Late Mesolithic or the Early Neolithic. It explores the evidence from cave and shell midden burial sites with early 4th millennium BC dates. There are examples from western Scotland of similar burial rites at Late Mesolithic Cnoc Coig and Early Neolithic Carding Mill Bay. There are also different styles of Neolithic midden burial in rock shelters at Raschoille and An Corran. There were also a number of other possible midden burials in other part of Britain. Cave burial practice could be considered as evidence for continuity between the Late Mesolithic and the Early Neolithic in these regions. There are cave burials with early dates, and these may provide indications of cave burial as a Late Mesolithic practice. However, it is more likely that these represent the very earliest manifestations of a ‘culturally’ Neolithic burial practice.