Seven scribes and illuminators, working in the scriptorium built by the crusaders in the Church of the Holy Sepulchre in Jerusalem, were involved in the creation of the psalter.
The scenes depicted are the Annunciation, Visitation, the Nativity, the Adoration of the Magi, the Presentation of Jesus at the Temple, the Baptism of Jesus, the Temptation of Christ, the Transfiguration, the Raising of Lazarus, the triumphal entry into Jerusalem (see illustration), the Last Supper, the Washing of the Feet, the Agony in the Garden, the Betrayal of Judas, the Crucifixion of Jesus, the Descent from the Cross, the Lamentation, the Harrowing of Hell, the Three Marys at the Tomb, and the Deesis.
One name, St. Martin of Tours, a saint popular throughout Europe, is written in gold, for unknown reasons.
Each month has a medallion with a sign of the Zodiac, illustrated in a Romanesque style with heavy Islamic influences.
They show influence from Italian and Islamic art, possibly suggesting that the artist was trained in Muslim-influenced southern Italy.
The scribe who wrote the psalms also wrote a series of prayers on folios 197–211, dedicated to nine saints: the Virgin Mary, St. Michael, St. John the Baptist, St. Peter, St. John the Evangelist, St. Stephen, St. Nicholas, St. Mary Magdalene, and St. Agnes.
The ivory covers, decorated with some small turquoise beads, show scenes from the life of King David and from the Psychomachia of Prudentius on the front side, and another king performing the six works of mercy from the Gospel of Matthew on the back side, both showing influence from Byzantine, Islamic, and western art.
The spine of the psalter is decorated with Byzantine silk and silver thread, as well as red, blue, and green Greek crosses, which are found in the royal arms of the kingdom.
It is also notable that aside from the capture of Jerusalem, the only crusader-specific dates in the calendar are the deaths of Melisende's parents, King Baldwin II and Queen Morphia.
The mixture of Catholic and Orthodox elements in the psalter may reflect Melisende's mixed upbringing.
In the historical grand strategy simulation game, Crusader Kings III, the Melisende Psalter is an object the ruler can collect if their spouse or lover is cheating on them, as a reference to Fulk's attempt to win back Melisende's favor with the gift during her affair with Hugh II of Jaffa.