The miniature portrait of the celebrated beauty Elizaveta Feodorovna (eldest sister of Empress Alexandra Feodorovna), painted in watercolor on ivory, is set in a frame made in 1901 by the Moscow firm of Feodor Lorie, which worked with the House of Fabergé.
The Roman numeral X at the top of the composition, as well as the years 1891 and 1901 located on either side of Elizaveta Feodorovna's monogram on the back of the medallion, refer to the ten-year anniversary of her husband, Grand Duke Sergei Alexandrovich (uncle of Nicholas II), holding the position of Governor General of Moscow.