This work shows that humans have been using the site for much of the last 48,000 years or more. Occupations bridge the Middle to Later Stone Age transition, which occurred sometime between about 40,000 and 25,000 years ago in southern Africa.

That transition is a time period where we see dramatic changes in the technologies people were using, including changes in raw materials selected for making tools and a shift towards smaller tools. These changes are poorly understood due to a lack of sites with occupations dating to this time. Knysna Eastern Heads Cave 1 is the first site on the southern coast that provides a continuous occupational record near the end of the Pleistocene (Ice Age) and documents how life changed for people living on the edge of the Palaeo-Agulhas Plain.

Before the Ice Age, people there collected marine resources like shellfish when the coastline was close to the site. As the climate began to cool and sea levels dropped, they shifted their focus to land-based resources and game animals.