Ochre is found at numerous Middle Stone Age (MSA) sites and plays a key role in early modern human archaeology. Here we analyse the largest known East African MSA ochre assemblage, comprising 40 kg of ochre, found at Porc-Epic Cave, Ethiopia, spanning a period of at least 4,500 years. Visual characterisation of ochre types, microscopic identification of traces of modification, morphological and morphometric analysis of ochre pieces and modified areas, experimental reproduction of grinding processes, surface texture analysis of archaeological and experimentally ground ochre facets, laser granulometry of ochre powder produced experimentally on different grindstones and by Hamar and Ovahimba women from Ethiopia and Namibia respectively, were, for the first time, combined to explore diachronic shifts in ochre processing technology. Our results identify patterns of continuity in ochre acquisition, treatment and use reflecting both persistent use of the same geological resources and similar uses of iron-rich rocks by late MSA Porc-Epic inhabitants. Considering the large amount of ochre processed at the site, this continuity can be interpreted as the expression of a cohesive cultural adaptation, largely shared by all community members and consistently transmitted through time. A gradual shift in preferred processing techniques and motions is interpreted as reflecting cultural drift within this practice. Evidence for the grinding of ochre to produce small quantities of powder throughout the sequence is consistent with a use in symbolic activities for at least part of the ochre assemblage from Porc-Epic Cave.