“Tells” are archaeological mounds formed by deposition of large amounts of anthropogenic material and sediments over thousands of years and are the most important and prominent features in Near and Middle Eastern archaeological landscapes. In the last decade, archaeologists have exploited free-access global digital elevation model (DEM) datasets at medium resolution (i.e., up to 30 m) to map tells on a supra-regional scale and pinpoint tentative tell sites. Instead, the potential of satellite DEMs at higher resolution for this task was yet to be demonstrated. To this purpose, the 3 m resolution imaging capability allowed by the Italian Space Agency’s COSMO-SkyMed Synthetic Aperture Radar (SAR) constellation in StripMap HIMAGE mode was used in this study to generate DEM products of enhanced resolution to undertake, for the first time, a systematic mapping of tells and archaeological deposits. The demonstration is run at regional scale in the Governorate of Wasit in central Iraq, where the literature suggested a high density of sites, despite knowledge gaps about their location and spatial distribution. Accuracy assessment of the COSMO-SkyMed DEM is provided with respect to the most commonly used SRTM and ALOS World 3D DEMs. Owing to the 10 m posting and the consequent enhanced observation capability, the COSMO-SkyMed DEM proves capable to detect both well preserved and levelled or disturbed tells, standing out for more than 4 m from the surrounding landscape. Through the integration with CORONA KH-4B tiles, 1950s Soviet maps and recent Sentinel-2 multispectral images, the expert-led visual identification and manual mapping in the GIS environment led to localization of tens of sites that were not previously mapped, alongside the computation of a figure as up-to-date as February 2019 of the survived tells, with those affected by looting. Finally, this evidence is used to recognize hot-spot areas of potential concern for the conservation of tells. To this purpose, we upgraded the spatial resolution of the observations up to 1 m by using the Enhanced Spotlight mode to collect a bespoke time series. The change detection tests undertaken on selected clusters of disturbed tells prove how a dedicated monitoring activity may allow a regular observation of the impacts due to anthropogenic disturbance (e.g., road and canal constructions or ploughing).