Accurate age-at-death estimates are essential for inferring health, identity, diversity, and demography within archaeological skeletal samples. Unfortunately, the macroscopic skeletal structures may be compromised by dysplastic, endocrine, and circulatory disorders. Cementochronology provides a reliable alternative approach for evaluating acellular cementum banding. Using cementochronology, we present an age-at-death estimate for a pre-Columbian, adult female with a combined skeletal dysplasia, achondroplasia and Leri-Weill dyschondrosteosis. Cementochronology has re-defined the age-at-death estimate between 30 to 34 years. These results not only assist in developing a more accurate age-at-death estimation and biological profile, but they also facilitate creating nuanced interpretations for a physically challenged, pregnant female in her Middle Woodland social context. Further, this analysis emphasizes the utility of cementochronology in estimating age-at-death of skeletal individuals with pathological conditions that compromise commonly used macroscopic methods and encourages researchers to consider this technique in paleodemography, paleoepidemiology, and forensic anthropology.