The newest studies of the Caucasus Paleolithic indicate movements of human groups between the northern and southern, and western and eastern parts of this region. In the Baksan river valley in the north-central Caucasus, there is known a large source of obsidian, which was transported to sites in the north-western Caucasus already in the Middle Paleolithic. However, no stratified Middle Paleolithic site was known in the source area until 2016 when we discovered here the first cave site of Saradj-Chuko cave. The article presents the first results of a comprehensive research of this site. The Saradj-Chuko cave is located just 6–7km from the important obsidian source that represents the only source of obsidian, which was highly valued in the past, in the Northern Caucasus, and about 70km from the Elbrus volcanic peak. A comprehensive study in Saradj-Chuko cave began in 2017. A small (∼8 sq. m) excavation was dug next to the 2016 test pit. We report a detailed description of the materials excavated from the main Middle Paleolithic occupational Layer 6B. The study of the lithic assemblage allows us to make a preliminary conclusion that Layer 6B represents an active habitation level where Neanderthals were engaged in intensive flaking of obsidian and usage of tools made predominantly from obsidian for butchering and consumption of hunting game. The laminar character of the stone industry distinguishes the Mousterian industry of the north-central Caucasus and probably the entire Terek river basin from the Eastern Micoquian industry that is represented in factually all Middle Paleolithic sites in the north-western Caucasus (Kuban river basin), as well as makes the Mousterian of north-central Caucasus similar to the Mousterian industries known in the north-eastern Caucasus and the Southern Caucasus. We suggest cultural connections and contacts among Neanderthal groups from these regions during the Middle Paleolithic period.