Not much is known about his role in Mesopotamian religion, though it is known that he could be regarded as a bow-armed warrior deity, as a divine cadastral officer or a judge.
[6] Due to Pabilsaĝ's role as the spouse of Ninisina it is presumed that he might have been designated by the similar masculine theonym Lugal-Isin.
[8] A god bearing this name is appointed as the deity of Isin in a passage from the myth Enmešarra's Defeat dealing with the assignment of cities to individual members of the Mesopotamian pantheon.
[13] However, Irene Sibbing-Plantholt argues that he did not possess healing qualities himself,[15] with the only possible exception being an unusual Old Babylonian text, PBS 10/213, whose translation is uncertain and which might equate him with Damu rather than ascribe such character directly to him.
[13] In the incantation series Udug Hul he is addressed as its "administrator", and he is accompanied by deities well known for their connection to the world of the dead, such as Ningishzida, Hušbišag and Bidu.
[21] In art Pabilsaĝ was depicted as a zazzaku, a type of official, identified by Manfred Krebernik as a cadastral officer, but it is also possible that based on the similarity of a figure sometimes depicted on kudurru (inscribed boundary stones) with the representation of Sagittarius in the Dendera Zodiac, it can be assumed that in later times in his astral aspect he could be represented as a centaur-like archer with a horse's body and a scorpion's tail.
[2] They came to be regarded as spouses no later than at this time, though it has been noted Pabilsaĝ is already attested in Ninisina's cult center, Isin, in the Early Dynastic and Old Akkadian periods.
[25] As attested in records from the ninth year of Amar-Sin's reign, a festival connected to Pabilsaĝ and his cult center Larak involved the travel of Ninisina to this city by boat.
[27] This goddess, whose name can be translated as "throne lady", occurs only in Emesal laments, and the hypothetical standard Sumerian ("Emegir") form Nin-ašte is not attested.
[13][27] Irene Sibbing-Plantholt proposes that this process reflected an attempt at providing Ninisina with a husband representing a city which traditionally held ideological significance, and that she might have completely absorbed Pabilsaĝ's previous spouse after Larak lost political relevance.
[2] A document from Puzrish-Dagan from Ibbi-Sin’s reign attests that offerings were provided in Isin for Pabilsaĝ and his family: Ninisina, Gunura, Damu and Šumaḫ.
[32] It is possible that in the local tradition of Nippur Pabilsaĝ s spouse was the sparsely attested deity Enanun, who came to be represented as a healing goddess in sources from the first millennium BCE.
[26] Pabilsaĝ is paired with Nintinugga in an Old Babylonian incantation in which multiple divine couples are asked to judge the patient, with the other deities mentioned including Tishpak and Ukulla, Zababa and Bau, Ninurta and Ninnibru and Ningishzida and Azimua.
[2] An early instance of the identification between them is attested in a širnamšub composition dedicated to Ninurta originally composed during the reign of the First Dynasty of Isin.
[36] Joan Goodnick Westenholz pointed out that interchange of traits between certain deities was also likely facilitated by the existence of multiple couples consisting of a warrior god and a healing goddess, citing Pabilsaĝ and Ninisina, Ningirsu and Bau and Ninurta and Ninnibru as examples.
[37] He points out inserting various deities into the family tree for political reasons would have a plausible precedent in the development of the traditions presenting Ningirsu and Nanna as Enlil's sons respectively during the reign of Gudea and the Third Dynasty of Ur.
[41] Pabilsaĝ is also mentioned in Bulluṭsa-rabi's hymn to Gula, in which the spouse of this goddess is similarly identified with a number of other gods.
[5] Douglas Frayne notes that based on the former it is possible to speculate that he was the main deity of a hitherto unidentified settlement in Lagashite territory.
[49] In the Ur III period he was worshiped in this area in the city of Urub, and in offering lists often appears alongside his wife Ninisina.
[43] He is already mentioned in sources from the Old Akkadian and Ur III periods, in the latter case appearing alongside Ninisina in offering lists.
[26] A text from Mari identified as a draft of an inscription for a stele commemorating a victory of Zimri-Lim mentions Pabilsaĝ.
[2] In the composition Ninisina and the gods (Nin-Isina F in the ETCSL naming system), Pabilsaĝ is addressed as the "beloved spouse" of the eponymous goddess, who "spent time joyously with him".
[24] In a fragmentary Sumerian flood myth dated to the late Old Babylonian period at the earliest[28] and presumed to reflect the tradition also documented in Atrahasis and in the flood myth which formed a part of the Epic of Gilgamesh,[55] the assignment of Larak to Pabilsaĝ is mentioned in an early section of the narrative which describes the assignment of five cities, the other four being Eridu, Sippar, Bad-tibira and Shuruppak, to their corresponding tutelary deities.