The fish represented is Syndodntis Schall, a type of Nile catfish that swims upside down at the surface of the water to catch insects which have fallen in. The Egyptians saw this behaviour and must have assumed the fish was breathing, so it became an amulet against drowning. These amulets were highly prized and intricately crafted. This one is minutely detailed in the rendering of the scales on the amethyst body. It would probably originally have had gold fins set into holes at the top and bottom and eyes of garnet. Fish amulets such as this one are first attested in the Old Kingdom and were worn either around young women's necks or in their braided hair to protect the wearer against drowning. Fish amulets reached the height of their popularity in the Middle Kingdom and were made of a variety of precious stones and metals. The carving on this amethyst example is particularly fine, indicating that it may have been a royal commission.
A story involving a fish pendant is preserved on the Middle Kingdom Papyrus Westcar and emphasizes the use of such a pendant in the daily lives of those who were close to water or might have reason to fear to drown. In it, the Fourth Dynasty King Khafre is being entertained by his sons with stories of miraculous happenings in the past. His son Baufre tells him of a story from the life of Khafre's father, King Snefru. King Snefru walked through his palace feeling agitated, he sought peace but could not relax and so he went to his chief lector priest Djadjaemankh for advice. The priest tells the king to gather a number of beautiful young women to row his boat on the lake and that the sight of them will relax him. The king did as the priest suggested and was enjoying his boating party when suddenly the rowing stopped. Snefru asked the women why they had stopped, and the leader of the women said she had been stroking her hair when a pendant made of fresh turquoise fell from her braid into the water. The king offered to replace it for her but she insisted that she preferred her own. The king, disappointed that his boating may be cut short called the lector priest for further advice. Djadjaemankh came to the lake where he stacked the water from half of the lake on top of the other half through magic and retrieved the pendant from the lake floor. Snefru is overjoyed to witness such a spectacular event and spent the rest of the day in a celebratory feast after awarding the priest with many gifts.