Isotta degli Atti (c. 1432/1433 - 1474) was born in Rimini, the daughter of Francesco degli Atti, a wealthy wool trader and banker. She became the mistress of Sigismondo Pandolfo Malatesta, Lord of Rimini, about 1446 after he noticed her while a guest of Francesco during restoration of his residence. They had a son, Giovanni, in 1447, though he lived only a few months. After the death of Sigismondo's second wife in 1449, he would take an unusual step and marry his mistress about 1455/1456. Isotta would become Sigismondo's heir, and after his death she would briefly rule Rimini with his son Sallustio.

The date of 1446 on the reverse of the medal, which appears on other medals commissioned by Sigismondo, does not refer to when the medal was created. Rather, it is an important year for Sigismondo, being the year when he defeated Francesco Sforza at Gradara, the ceremonial inauguration of Castel Sismondo was held, and he began his affair with Isotta. As with other medals Sigismondo had made, medals of Isotta were placed for posterity in the foundations of building projects.

Isotta was only the second woman to be commemorated on a medal during the Renaissance. The imagery of the ponderous pachyderm on the reverse provides an interesting pairing with the portrait of the young lady on the obverse. The elephant was an emblem of the Malatesta family, representing regal strength and fame that confers immortality. Relating to the subject of the medal, Isotta, elephants were associated in classical times with intelligence, piety, and prudence. It has also been suggested that the elephant reverse on this medal is meant to symbolize Isotta's share in Malatesta fame and power.