A scanty but varied ensemble of finds challenges the idea that Neandertal material culture was essentially static and did not include symbolic items. In this study we report on a fragmentary Miocene-Pliocene fossil marine shell, Aspamarginata, discovered in a Discoid Mousterian layer of the Fumane Cave, northern Italy, dated to at least 47.6-45.0 Cal ky BP. The shell was collected by Neandertals at a fossil exposure probably located more than 100 kms from the site. Microscopic analysis of the shell surface identifies clusters of striations on the inner lip. A dark red substance, trapped inside micropits produced by bioeroders, is interpreted as pigment that was homogeneously smeared on the outer shell surface. Dispersive X-ray and Raman analysis identify the pigment as pure hematite. Of the four hypotheses we considered to explain the presence of this object at the site, two (tool, pigment container) are discarded because in contradiction with observations. Although the other two ("manuport", personal ornament) are both possible, we favor the hypothesis that the object was modified and suspended by a 'thread' for visual display as a pendant. Together with contextual and chronometric data, our results support the hypothesis that deliberate transport and coloring of an exotic object, and perhaps its use as pendant, was a component of Neandertal symbolic culture, well before the earliest appearance of the anatomically modern humans in Europe.