Open-air Paleolithic sites from the last glaciation are best known from Eastern Europe and, to a lesser extent, Western Europe and the Levant. This report describes one, Site 55, from northern Pakistan, a region that has one of the best preserved loess landscapes outside Eastern Europe and China. The site comprises an unusual mixture of natural and artificial features. Most of it lies on a tilted conglomerate sheet that provided the quartzite used for making stone artifacts. Site 55 also contains a structure that includes a low wall footing, a pit, and a stone-lined niche, all associated with a freshly flaked stone assemblage that included blades. Thermoluminescence (TL) dating of the overlying loess indicates that this assemblage is at least 45,000 years old, and thus could be regarded as "initial Upper Paleolithic" in the sense used in the Levant. Explanations of the site are hindered by an absence of bone and charcoal. Its overall features, however, conform most closely to the type of lithic procurement sites evidenced in western Russia; an additional observation is that the site may also have been used for skin working.