This is an ivory group made in the early 15th century, in France, probably Paris. The pierced relief depicts the Virgin and Child with St. John the Baptist, St. Louis of Toulouse and a kneeling nun. The relief probably originally formed the left leaf of a small diptych, with the Crucifixion on the right leaf. The format of the group, with a kneeling donor and intercessory saints standing behind, was popular amongst the commissioners of courtly devotional images at the end of the fourteenth and beginning of the fifteenth century. The style of the figures and the low relief carving, coupled with a love of detail and preciosity, immediately link the relief to other ivory carvings associated with the Parisian and Franco-Flemish workshops of the early fifteenth century.

The devotional diptych is in many ways the object type most associated with the notion of Gothic ivory carving. The earliest examples probably date to the 1240s; these are complex, large and ambitious works that emerged, somewhat surprisingly, with no obvious precursors. The owners of ivory diptychs sometimes appear within their images. Such portraits indicate that they were special requests on the part of their commissioners, and they parallel the similar figures that appear in manuscripts and panel paintings of the period. The iconography of Gothic diptychs oscillated between two poles. The first of which is the desire to present narratives (Life of Christ and Virgin Mary) for envisaging. The second was the use of non-narrative images to form the focus of devotion.