Humans have ornamentally carved ivory since prehistoric times, and much of the prehistoric work reveals information about the use of tools during the carving's time period. The ivory figure of Khufu, for the builder of the Great Pyramid, is considered a masterpiece. Ivory carvings have been discovered in the tombs of ancient Chinese rulers. Since the late Roman era ivory has been a popular medium for Christian art. Many boxes, that held religious relics, or costly jewelry were made of ivory. The ivory was usually obtained from the tusks of live elephants in India, and in Roman times, from North Africa. Ivory harvesting led to the extinction, or near-extinction of elephants in much of their former range.
Late Roman ivory diptychs were issued by the consuls, civil officers who played an important administrative role until 541. Consular diptychs consisted two carved panels joined by hinges with the image of the consul. Religious diptychs were similar but with the images of Christ and the Theotokos. The laters presumably stood on the altars during liturgy.
Such ivory panels were used as book-covers from the 6th century. It was necessary to assemble such covers from usually five smaller panels because of the limited width of the tusk. This assembly suggested a compositional arrangement with Christ or Mary in the centre and angels, apostles and saints in the flanking panels. Carved ivory covers were used only for the most precious religious books.
The most important Late Antique work of art made of ivory is the Throne of Maximianus. The cathedra of Maximianus, bishop of Ravenna (546-556), was constructed entirely of ivory panels. It was probably carved in Constantinople and shipped to Ravenna. It consists of decorative floral panels framing various figured panels, including one with the complex monogram of the bishop.
Typical Byzantine ivory works after the Iconoclastic period were triptychs. The most remarkable example is the Harbaville Triptych from the 10th century with many figurative panels. Such Byzantine triptychs could only have been used for private devotion because of their relatively small size. Another famous 10th century ivory triptych is the Borradaile Triptych with only one central image (the Crucifixion). The Romanos Ivory is similar to the religious triptychs but its central panel shows Christ crowning Emperor Romanos and Empress Eudokia. There are different theories about which Byzantine ruler was made for the triptych. One possible solution is Romanos II that gives the date of production between 944 and 949.
Most Byzantine ivories were gilded and coloured but only scant traces survived of their surface colouring. It seems that ivory carving declined or totally disappeared in Byzantium after the 12th century.
Much of ivory carved in the last 200 years has been for East Asian jewelry and ethnic crafts. Large amounts of ivory continues to be consumed for East Asian traditional art and ethnic hand stamp dies, even in the face of near-extinction of African and Asian elephants.
Ivory has been gradually replaced by plastics in key commercial application such as piano keys.
Very little ivory carving is done in the United States since the middle 20th century, as a result of extinction concerns.