The occipital bone of Neandertals contains an association of morphological features that is considered characteristic of this fossil human population. One of the possible autapomorphic traits of Neandertals is the presence of a suprainiac fossa, a horizontal oval-shaped depression located on the occipital plane. The question of whether suprainiac depressions observed on Neandertals and in other human samples are homologous has been widely discussed. The present study provides a detailed anatomical description of the fossa and of the underlying internal bone composition for Neandertals of various geographical and chronological origins, and of different developmental stages. The suprainiac fossa is systematically present on Neandertals from the earliest developmental stages as well as at the beginning of the differentiation of the Neandertal lineage. A similar pattern for the structural composition of the bone is found among all analyzed Neandertals (i.e., the suprainiac fossa corresponds to a thinning of the diploic layer with no substantial remodeling nor variation in the external table thickness in this area). On the contrary, the occipital depressions present on a sample of anatomically modern humans from Europe and Africa correspond to a resorptive area of the external cranial surface only. These depressions also differ in shape, disposition, and aspect on the external cranial surface from those fossae on Neandertals. We demonstrate that the depressions described in anatomically modern humans, as well as other hominin species, are not homologous to the suprainiac fossa of Neandertals. Consequently, we confirm the autapomorphic status of the Neandertal suprainiac fossa.