The formation is significant for its association with the Great Sioux War of 1876-77, and its connection with Sitting Bull's visionary sun dance of early June 1876 which prophesied victory at the Battle of the Little Bighorn.

They are formed out of a sandstone promontory originally part of the hills that rise west of the creek, with erosive forces removing the intervening material.

The panels depict themes and images common to other rock art sites found throughout the region.

This is interpreted by the Lakota and Cheyenne as showing the vision of Sitting Bull in which he predicted the victory at Little Big Horn during a sun dance held here.

The Deer Medicine Rocks are the first National Historic Landmark designated for its association with the Great Sioux War that is not a battlefield, and the first to provide a distinctly native view of the campaign.