Egyptian headrests show many variations in material, and in form they range from the plain to the elaborate. Usually they consist of three parts: a flat base, a small central pillar, and a curved support on which the head rested. In this ivory example, which has no close parallel in Egyptian art, the central pillar is formed mainly of a figure of the god Shu kneeling and holding with upraised arms the curved head support. Looped over each of his shoulders is the hieroglyphic sign for "protection". Two couchant lions, carved almost in the round, are on the top of the base.

Shu was the god of the air and consequently his image was used as its symbol. According to legend he brought chaos to an end, at the creation of the universe, by raising the sky (symbolized by his daughter Nut) high above the earth (symbolized by his son Geb). It was an action that had to be maintained continuously; failure to do so would result in the fall of the sky and a return to chaos.

The ancient Egyptians regarded the head as the seat of life and consequently its preservation was thought to be of particular importance for continued existence after death. It could not, however, function without the help of magic, which could be obtained by various means, one of which was an amulet in the form of a headrest, either model or actual. Tutankhamun possessed four full-size headrests and one model that was made of iron and placed in the linen wrappings of his mummy at the back of the head - the natural position for such an object. A spell in the Book of the Dead (No. 166) has been interpreted as attributing to the headrest the power of resurrection, and another spell (No. 55) sometimes written on headrests identifies these objects with the god Shu, probably because air was a vital necessity for life.

In order to show symbolically that the base of the headrest represents the earth or its god Geb, the artist has carved two lions, one at each end of the base, representing the two mountains on the eastern and western horizons between which the sun rose and set. As a development from this conception, two squatting lions placed back to back became a symbol for yesterday and tomorrow. On the shoulder of each lion is a kind of rosette, the interpretation of which is uncertain. It has been variously explained as representing a tuft of hair and an ornament placed on live lions at the court of a king. Its occurrence as an artistic feature is not confined to Egypt; it is also found in the art of Syria, Mesopotamia and Persia. The position of the tail, lying beside the body, is a peculiarity of the period. At other times it was curled over the flank.

Behind the figure of Shu is the hieroglyphic inscription: "The good god, son of Amun, king of Upper and Lower Egypt, lord of the Two Lands, Nebkheperura [i.e. Tutankhamun], given life like Ra for ever".

The object is made of two pieces of ivory joined by a wooden dowel in the middle of the figure of Shu and held together by four gold nails. Details are inlaid with a blue pigment.