The fragmentary early Late Pleistocene, early modern human remains from Zhirendong, south China, present a suite of dentoalveolar pathologies and anomalies. The lesions include lower molar buccal alveolar resorption (Zhiren 1), massive dental caries in a mandibular molar associated with hypercementosis (Zhiren 2), and bilateral mesial premolar (P3) periapical lesions (granulomata with a probable left abscess) (Zhiren 3). The Zhiren 3 periapical lesions, given their bilaterality and the non-pathological incisor and canine alveoli, suggest dens evaginatus, although absence of the Zhiren 3 dentition prevents full evaluation of this diagnosis. These periodontal abnormalities join a number of similar lesions in Pleistocene humans, of varying severity. The carious lesion is noteworthy, given the rarity of them in the Pleistocene human fossil record. In addition, Zhiren 3 exhibits unilateral P3 rotation and bilateral I1 rotation (winging).