Its dramatic imagery shows the Virgin Mary holding the Christ Child within a tree, surrounded by black, withered branches forming a crown of thorns.

It was unattributed until 1919, when the art historian Grete Ring associated its iconography and painterly style with Christus and through a detailed examination of its imagery assigned its current title.

The iconography is presumed to be related to the devotions of Confraternity of Our Lady of the Dry Tree of Bruges, which Petrus Christus and his wife Gaudicine joined so as to integrate themselves into the city's upper realms of society.

[3] The panel adopts an illustionistic scale, perhaps influenced by van der Weyden's Durán Madonna, in which Mary is placed in an undefined space that seems much smaller than her physical presence.

The art historian Maryan Ainsworth notes that this is typical of Christus's smaller panels, some of which can be considered miniatures, and compares it to contemporary illuminated manuscripts.

Ainsworth sees the panel as "almost a literal translation of de Deguileville's text" – the green graft symbolizes Mary who in turn gives birth to the Christ child, "the fruit of this growth and Savior of Mankind".

[21] The orb and cross in his hands and the spiny thorns fashioned into a surrounding crown indicate his role as Savior, while the dry tree itself may be a representation of both the Fall of Man and Redemption.

[21] The fifteen golden A-shaped letters hanging from the branches are generally interpreted as abbreviations for the Ave Maria ("Hail Mary") prayer.

[21] Their number may allude to the 150 Hail Mary's recited in the contemporary rosary; that is 15 rounds of 10 decades), although this form did not become popular until 1475, some ten years after Christus' panel.

[21] The art historian Bernhard Ridderbos sees the panel as a unique "miraculous cult image", rather than a typical late-medieval illustration of a biblical scene.

[10] That year Ring published the first analysis of the painting, attributing Christus in her article "Onse Lieve Vrauwe ten Drooghen Boome" for the Zeitschrift für bildende Kunst.