The panel is damaged at the top left and bottom right, the upper and lower borders have been cut down, and the right border may have been trimmed. The eyes of the three adult figures and the two animals are drilled and set with black glass. A later hole is at the upper centre. The verso shows clearly the striation of a cross-section of walrus ivory. There is an Ink note, 'The Nativity', probably by W.H. Rolfe.
The Virgin lies on a wooden bed, her turbanned head supported on a pillow held by the midwife, her right hand, on the edge of the bed, gestures down to the Child below. The finely-rendered folds of the sheet draw attention to the curious perspective of the bed itself, a problem which is not alleviated by the additional leg to the right of the animals. (The lower part of the leg at bottom right has been broken off.) Joseph sits on a stool with a cushion top rigth. The swaddled Child in the crib below, set in apparently rocky ground, is adored by ox (left) and ass (right).