Louis XII (1462-1515) became King of France in 1498 after the death of his cousin, Charles VIII. A popular ruler, he earned the soubriquet "Father of the People". Anne (1477-1514) was the daughter of Francis II, Duke of Brittany, and became Duchess of Brittany upon her father's death in 1488. Married first by proxy to Emperor Maximilian I in 1490, she was then married to Charles VIII in 1491. Upon Louis XII's accession, he had his marriage to Charles VIII's sister, Joan, annulled, and then married Anne in 1499.

Louis XII and Anne made a state visit to Lyon in March of 1500 (this actually being Anne's second such visit to the city). The register of deliberations of the consulate of Lyon for March 1499 records that, "after dinner ... the counselors appointed Jehan Lepère and Nicolas Leclerc, carver of images, to make the medal ... to be given to the Queen, the King on one side and the Queen on the other, with a scattering of fleurs-de-lis and ermines where they belong, and a lion beneath on each side, in the circle of the inscription which will be advised and given to them. Which medal will be made, as soon as possible." The model for the medal was made by Nicolas Leclerc and Jean de Saint-Priest; the medal itself was made by Jean Lepère and his brother Colin, along with an unknown founder. A specimen in gold was presented to the queen upon her entry to the city, and is now lost (likely quickly reduced to bullion for the royal treasury).

This was the first cast medal made in France, as the previous few excursions in medallic art were struck pieces largely in medieval style. While modelled and cast similarly to the Italian medals of the day, this piece still retains medieval qualities, especially in the prominence of heraldic devices in the fields. The fleurs-de-lis represent the French monarchy; the ermine tails are an emblem of Anne's native city of Brittany, were a personal device of hers, and were in general a symbol of purity. The lion on each side below the busts is an emblem of the city of Lyon (which is referred to in the inscription by its ancient Roman name, Lugdunum).