Ludovico Maria Sforza (1452-1508), called Ludovico il Moro, was the fourth son of Francesco I Sforza. While his young nephew Gian Galeazzo Sforza was Duke of Milan, Ludovico became regent in 1481, and later became duke after his nephew's suspicious death in 1494. Ludovico was a patron of Leonardo da Vinci, who worked in Milan from 1482-1499, and commissioned the famed mural painting of The Last Supper in the refectory of the Convent of Santa Maria delle Grazie.

This medal refers to the acquisition of Genoa by Ludovico in 1488, when the Doge of Genoa, Cardinal Paolo di Campofregoso, ceded power to him. The reverse inscription and inscription on the dais allude to Ludovico's peaceful efforts to recover Genoa and the choice of the Genoese citizens by public deliberation to return to the protection of Milan. The reverse design has been traditionally interpreted as Paolo di Campofregoso, seated on the dais, receiving Ludovico and the procession of horsemen. However, Pollard identifies the figure seated on the dais as Gian Galeazzo, receiving the Genoese delegation being led by Ludovico. In either case, the scene is imagined, as neither Ludovico nor Gian Galeazzo went to Genoa to receive homage. The twin lighthouses from the harbor of Genoa, shown in the background of the reverse, would become a favorite impresa of Ludovico.