This is a bone relief made in the second half of the 15th century in Germany, possibly the Rhenish area. It is carved with the Virgin and Child between St. John the Evangelist and St. Catherine.
The relief was originally in the form of a circular medallion with a pierced background, the upper half of the border having broken off. It must originally have been within a frame and would have served as a pendant. The use of bone rather than ivory and a copper-alloy rather than silver frame, indicates that the medallion was not intended for the élite market.

This miniature ivory reliefs should be viewed in the same light as their kleinplastik counterparts in precious metals and enamel. And the later pieces, from the second half of the fifteenth to the early sixteenth century, are also often comparable to works in other materials, such as the more numerous mother-of-pearl roundels. Both drew on the same graphic sources and brought sacred images into the possession of the pious.