Parmigianino crammed two interlocking studies of the Holy Family, one drawn upside down from the other, onto this sheet of paper. At the bottom, the Madonna sits on the ground holding her right breast, while a female attendant beside her holds the Christ Child. When the sheet is turned the other way up, a variant of the same group appears, this time including the Madonna and Child, perhaps with Saint Elizabeth and the infant John the Baptist.
The two studies overlap at the center, showing how rapidly yet harmoniously the artist's train of thought sprang from one study to the other. The heads interlock across the middle of the sheet, and the bodies seem to mirror each other. Parmigianino then made his choice between the two, reinforcing with brush and wash the chiaroscuro in the more fully resolved one. An early drawings collector probably cut the sheet from a larger leaf of studies.
Parmigianino almost certainly made these studies in preparation for a print of The Adoration of the Shepherds.