Pisanello studied John VIII Palaeologus, the penultimate emperor of Byzantium, while he was attending the Council of Eastern and Western Churches in Ferrara and Florence in 1438 to 1439, sketching him both formally dressed and mounted for hunting. The medal's distillation of the drawings emphasized exotic aspects of the emperor's appearance: on the obverse, the tall hat with a large ruby on top and a sharp brim, the coiled hair, and the pointed beard; on the reverse, the small horse and Turkish style archery equipment.

Inscriptions: On the obverse: around field (in Greek), +IωANNHC·BACIΛεVC·KAI·AVTOKPATωP·PωMAIωN·O·πAΛAIOΛΓOC [John, king and emperor of the Romans, Palaeologus]; reverse: around the top (in Latin), .OPVS.PISANI.PICTO/RIS. [the work of Pisano the painter]; around the bottom (the same inscription in Greek), εPΓON·TOV·πICANOV·ZωΓPAΦOV [the work of Pisano the painter]

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