Archaeological sites with surface hearths are a ubiquitous feature across the arid zones of the Arabian interior. At Jebel Oraf, in the Jubbah basin of the Nefud Desert of northern Arabia, numerous grinding stone fragments were found in association with hearths, though the original purpose of these stones was unclear owing to the poor preservation of faunal and botanic remains. Here we describe results from use-wear analysis on five grinding tools at Jebel Oraf, demonstrating that such artefacts were used during the Neolithic for plant processing, bone processing, and pigment production. Grinding stones were often broken up after initial use and fragments were subsequently re-used for alternative purposes, before finally being placed on hearths or discarded. More specifically, plants were ground or prepared and possibly cooked in the hearths, and bones were processed as well. The analyses also highlight the importance of pigment processing at Neolithic sites and provide a link to painted rock art. The frequent use of pigment in the archaeological record suggests that pigment was widely used, and that Neolithic painted art may have been more common than the surviving images suggest.