ObjectiveThis paper explores dental diseases and wear as a proxy for dietary patterns in Hellenistic-early Roman Menainon. MaterialsThis study includes 166 individuals (4th-1st c. BCE). MethodsCarious lesions, dental calculus, antemortem tooth loss, and dental wear were recorded to explore male-female and adult-juvenile differences, and to position Menainon in the broader Hellenistic/early Roman world through comparisons with published data from other sites. ResultsMales and females showed similar rates of dental diseases. Dental wear, in contrast, was systematically greater in males. Caries rates were high in both adults and juveniles, but adults showed more calculus. The population from Menainon had higher frequencies for calculus and carious lesions compared to contemporary Italian and Greek assemblages, and a similar frequency for antemortem tooth loss. ConclusionSome sex-related differences in the dietary patterns of the Menainon population were visible but small. The diet of adults and juveniles must have been similar in terms of carbohydrate consumption but different with regard to protein consumption. The high frequency of carious lesions and calculus compared to other Greco-Roman sites suggests that this population must have had good access to dietary resources (protein and carbohydrates). SignificanceThis paper provides insights on gender (sex-related) and age divisions in the Hellenistic/early Roman society through the exploration of food consumption in a Sicilian assemblage. LimitationsDividing the assemblage by sex and age group reduced considerably the sample size. Suggestions for further researchStable isotopes and dental microwear analyses should be used to investigate dietary patterns further.