Projecting from a white marble medallion, the face of the popular octogenarian Pope Alexander III looks out with informal candor. The medallion format, usually reserved for tomb monuments, here was chosen to represent a still-living figure. The pope wears a non-liturgical cap and cape usually worn for informal audiences. His smooth clothing contrasts with his sagging, aging flesh. This un-idealized, casual image is very rare in papal portraiture of the 1600s.

Both the base and the double-headed eagle, symbol of the Pope's Ottoboni family, were carved from a single piece of bigio antico marble. The sculptor skillfully manipulated the color of the stone so that the white-and-gray veined portion comprised the base while the darker, black-and-gray part of the stone was used for the eagle.

The sculpture was a gift from Cardinal Francesco Barberini, whom Alexander had made a cardinal in 1690.