Ornaments such as beads are among the earliest signs of symbolic behavior among human ancestors. Their appearance signals important developments in both cognition and social relations. This paper describes and presents contextual information for 33 shell beads from Bizmoune Cave (southwest Morocco). Many of the beads come as deposits dating to >= 142 thousand years, making them the oldest shell beads yet recovered. They extend the dates for the first appearance of this behavior into the late Middle Pleistocene. The ages and ubiquity of beads in Middle Stone Age (MSA) sites in North Africa provide further evidence of the potential importance of these artifacts as signals of identity. The early and continued use of Tritia gibbosula and other material culture traits also suggest a remarkable degree of cultural continuity among early MSA Homo sapiens groups across North Africa.