Saint John of the Ladder, one of the greatest figures of Orthodox Church monasticism, and abbot of the Sinai Monastery in the early seventh century, authored the Ladder of Divine Ascent, hence his epithet. The book guides monks through thirty rungs, starting with the renunciation of worldly things, to perfection. In this composition, the monks are assisted by angels in their struggle to reach the top, where Christ awaits them. Saint John of the Ladder is already at the top. He is accompanied by the bishop Antonius, to whom the icon appears to have been dedicated.
The portrayal in an icon of this particular theme remains unique to this day.