Three grinding stones from Shizitan Locality 14 (ca. 23,000–19,500 calendar years before present) in the middle Yellow River region were subjected to usewear and residue analyses to investigate human adaptation during the last glacial maximum (LGM) period, when resources were generally scarce and plant foods may have become increasingly important in the human diet. The results show that these tools were used to process various plants, including Triticeae and Paniceae grasses, Vigna beans, Dioscorea opposita yam, and Trichosanthes kirilowii snakegourd roots. Tubers were important food resources for Paleolithic hunter–gatherers, and Paniceae grasses were exploited about 12,000 y before their domestication. The long tradition of intensive exploitation of certain types of flora helped Paleolithic people understand the properties of these plants, including their medicinal uses, and eventually led to the plants' domestication. This study sheds light on the deep history of the broad spectrum subsistence strategy characteristic of late Pleistocene north China before the origins of agriculture in this region.