Her work consists of paintings, drawings and photographs of everyday objects, including pears[2][3] and rolls of toilet paper.

[5][7] Alf first became recognized as a nationally significant artist for her 1970s "cylinder paintings," each of which depicts a toilet paper roll positioned like a monument on an empty stage.

[8] In the late 1970s Alf turned to making graphite drawings of fruits and vegetables which she arranged like actors on a stage, acting out psychodramas.

She has been keenly attentive to every nuance of surface and value and shows enormous reverence for the integrity and expressive potential of the drawing medium".

The stem of the pear in the drawing is shown as if reaching towards golden light, suggesting that Alf's tormented friend had at last found peace with the universe at large.

[11] In the 1990s, Alf focused on a single color in a series of monochromatic red paintings with subtle patterning and variations in texture.

Concurrent with the 1970s cylinder paintings, Alf made photographs of toilet paper rolls as a means of studying color.

2002, Alf responded to the events of September 11, 2001, by creating a visual metaphor for a new metropolis, which she did by photographing an arrangement of several glass objects that glisten as they reflect sunlight.