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Venosa-Notarchirico is a musealized Lower Paleolithic site in southern Italy (Basilicata), where a human femoral shaft was discovered in 1985. The fossil specimen can be evaluated in the new light of excavations started in 2016, which provide a more updated and extensive picture of the site, including the crucial Ar/Ar date of 661-614 ka for the human specimen. This makes the fossil diaphysis from Venosa-Notarchirico (Vn-H1) the oldest fossil hominin found so far in the Italian peninsula, associated with the earliest evidence of genuine Acheulean in Europe. In this paper, we report a comparative morphometric analysis of this femur, as well as a paleopathological reappraisal of the periosteal alteration that affects the specimen, supported by an unpublished histological analysis. Vn-H1 represents the proximal two-thirds of a right femur lacking the epiphyseal region. We argue it belonged to an immature individual, possibly a juvenile (late adolescent). Its features suggest that the specimen may refer to an archaic (i.e. , non-modern) human species, also showing morphological differences compared to fossil samples of the Neanderthal lineage. We also support the identification of a pathological condition affecting Vn-H1, particularly evident in some preserved portions of the mid-shaft as described here. Its etiology is discussed after differential diagnosis, which led us to suggest an alteration of inflammatory origin, viewed as a nonspecific periosteal response. This pathology may have been roughly concomitant with the death of the individual. • Vn-H1 represents the oldest human fossil specimen ever found in Italy within one of the earliest Acheulean sites in Europe. • The age of Vn-H1, dated Ar/Ar at 661-614 ka, takes advantage of the recent new excavations at the Venosa-Notarchirico site. • Both morphology and morphometry of the human specimen suggest an age at death of the individual to the late adolescence. • Palaeopathological observations, supported by unpublished histological data, suggest the nature of the periosteal alteration. [ABSTRACT FROM AUTHOR]