In this moral work, the triumph of Death over mundane things is symbolized by a large army of skeletons razing the Earth. The background is a barren landscape in which scenes of destruction are still taking place. In the foreground, Death leads his armies from his reddish horse, destroying the world of the living. The latter are led to an enormous coffin with no hope for salvation. All of the social institutions are included in this composition and neither power nor devotion can save them. Some attempt to struggle against their dark destiny while others are resigned to their fate. Only a pair of lovers, at the lower right, remains outside the future they too will have to suffer.

This painting depicts a customary theme in medieval literature: the dance of Death, which was frequently used by Northern artists. Brueghel casts the entire work in a reddish-brown tone that gives the scene an infernal aspect appropriate for the subject at hand. The profusion of scenes and moralizing sense applied by the artists are part of Hieronymous Bosch's influence on this work.

This painting belonged to Queen Isabel Farnesio and was at the La Granja Palace in 1745.