The southern African coastlines have long been the focal point of Middle Stone Age (MSA) research in the subcontinent. Less is known, however, about contemporary developments in the interior. The 80,000-year old lithic assemblage from Melikane, a highland rockshelter in the Maloti-Drakensburg Mountains, currently represents Lesotho’s oldest chronometrically dated archaeology. Melikane’s montane environment would have presented unique challenges to early humans due to its rugged topography, lower temperatures, and sparsely distributed floral and faunal resources. Questions arise: what adaptations allowed continuous occupation of the region? Were technologies specifically tailored for life in highlands or a result of cultural ties with lowland populations? Analysis of the Last Interglacial stone tool assemblage from Melikane suggests that these foragers persisted by creating regionally adapted technologies. Rather than reaching out to coastal populations to create “safety nets,” highlanders adapted in situ and were confined to circumscribed social networks. These results imply significant behavioral flexibility early on in the Late Pleistocene, further increasing our understanding of the evolution of modern humans.