The more moderate impact of Old World infectious diseases (e.g., smallpox, measles, typhus, plague, influenza) and the lower level of depopulation during the Spanish conquest and colonization of the Philippines as opposed to the large-scale demographic collapse experienced by other European colonies particularly in the Americas remain a relevant matter worthy of continuing investigation. This dissimilar experience is chiefly attributed to three probable reasons: (1) previously acquired immunity to Old World diseases through trading contacts with Asia; (2) relatively benign character of Spanish conquest in the Philippines and; (3) the particular geography of the islands and their small and dispersed population incapable of sustaining acute infections indefinitely. Much of these studies, however, are mostly reliant on and limited to colonial documents, dictionaries, and related information from other Asian countries. The utility of archaeologically recovered human skeletal remains as valuable primary source of evidence on ancient health and disease, especially in the absence of written records, is hardly explored in the Philippines. It is then, the aim of this paper, to present the first palaeopathological data on infectious diseases drawn from the examination of human skeletal remains from Ille Cave in Northern Palawan. Preliminary macroscopic and radiological assessments reveal the probable presence of treponemal infections, tuberculosis, and several non-specific infectious diseases on adult individuals relatively dated to the mid-18th century. This research provides direct evidence for an otherwise documentary-based assessment on the consequences of Spanish and American colonization to the overall health and disease vulnerabilities of Filipinos.