The emergence of technologies to culturally modify the appearance of the human body is a debated issue, with earliest evidence consisting of perforated marine shells dated between 140 and 60 ka at archaeological sites from Africa and western Asia. In this study, we submit unpublished marine and estuarine gastropods from Blombos Cave Middle Stone Age layers to taxonomic, taphonomic, technological, and use-wear analyses. We show that unperforated and naturally perforated eye-catching shells belonging to the species Semicassis zeylanica, Conus tinianus, and another Conus species, possibly Conus algoensis, were brought to the cave between 100 and 73 ka. At ca. 70 ka, a previously unrecorded marine gastropod, belonging to the species Tritia ovulata, was perforated by pecking and was worn as an ornamental object, isolated or in association with numerous intentionally perforated shells of the species Nassarius kraussianus. Fluctuations in sea level and consequent variations in the site-to-shoreline distances and landscape modifications during the Middle Stone Age have affected the availability of marine shells involved in symbolic practices. During the M3 and M2 Lower phases, with a sea level 50 m lower, the site was approximately 3.5 km away from the coast. In the later M2 Upper and M1 phases, with a sea level at −60 m, the distance increased to about 5.7 km. By the end of the M1 phase, when the site was abandoned, Blombos Cave was situated 18–30 km from the shoreline. We use the new Blombos evidence and a review of the latest findings from Africa and Eurasia to propose a testable ten-step evolutionary scenario for the culturalization of the human body with roots in the deep past.