The pendant is made by two ovals hinged together, decorated with polychrome enamels and a frame set with forty-three rubies.
The principal side was meant to contain a portrait (miniature, cameo or relief in gold), now lost, around which ran the inscription "per tot discrimina rerum" ("through all adversities").
The other half still has the mother-of-pearl plaque incised with Noah’s ark sailing in a stormy sea. On the frame we read: "sevas tranquila per undas" ("calm between the raging waves").
The Victoria and Albert Museum in London has a very similar pendant with the portrait of Queen Elizabeth I, who seems to have given it to her councillor Thomas Heneage. It is likely that the Poldi Pezzoli medallion was likewise given by the queen to one of her admirals (Drake or Hawkins) after the Spanish Armada was defeated by the English fleet in 1588.