Mosaic of small colored stones or tiles has been a method of decoration for millennia. Exquisite examples can be found throughout the ancient Mediterranean. The mosaics inspiring this ketubah include those at Beit Alpha in (what today is known as) northern Israel, Masada (4th-6th centuries C.E.), Na’aran (north of Jericho in the Jordan Valley, dating to c. 530 C.E.), and Hammath Tiberias synagogue (early 4th century C.E.).

The quote wrapping the ketubah is a common wedding verse; it reads (in English): “Still can be heard in the cities of Judah and the outskirts of Jerusalem, the voice of joy and the voice of gladness.” Symbols within the mosaic include two intertwining ropes, pomegranates (a traditional symbol of fertility), and olive branches (symbol of peace). The landscape at the top of the ketubah shows two olive trees growing together, their lower trunks forming the Hebrew letter shin, the holy designation commonly found on mezuzot. A stylized Jerusalem graces the background.