This hand scroll was one of the over 14,000 complete paper scrolls and fragments acquired by Sir Marc Aurel Stein in 1907 from among the trove of paintings and documents stored in Cave 17 of the Mogao complex. It depicts the judgment of the Ten Kings of Hell, although the scroll is damaged and only five of the kings remain.

The painting serves as an illustration of the Ksitigarbha Sutra, a text used to teach the concept of karmic retribution. The sutra describes the consequences one creates for oneself through immoral behavior, with graphic descriptions of the horrors that await evildoers in the various layers of the Buddhist hell. This apocryphal sutra is written in the form of a discourse presented by the Buddha in praise of the bodhisattva Ksitigarbha and celebrated vow to renounce Nirvana until he has emptied all the ten hells of tormented souls.

The hand scroll, however, focuses on the judgment of Hell's Ten Kings. According to the sutra text, departed souls must pass before each of these demonic judges (presented in the form of Confucian bureaucrats) and suffer their judgment. In section one, the souls file in front of the Kings, with the wicked burdened by large wooden collars and chains, while the virtuous bearing sutras and images of the Buddha as evidence of their piety. In section two, one of the Kings has already passed judgment on one unfortunate, who has been sentenced to a flogging.

A separation in the continuity of the scroll occurs before and after section three, which illustrates the final judged deciding into which of the Six Realms of Existence the spirits will be reborn . Virtuous souls are allowed to be reborn in the realms of the Devas (Gods, goddesses and celestial beings) , the Asuras (Lesser gods or titans), or the Human Realm. Evildoers are reborn in the realm of Animals, the Pretas (hungry ghosts), or kept in hell to suffer brutal punishment by animal-headed demons.

It is not until the final scene in section four that we see the appearance the bodhisattva Ksitigarbha , garbed in the robes of a Buddhist monk. He stands outside a flaming city with iron walls, inside which the damned suffer various grisly torments. Other souls, driven by bull- and horse-headed demons, appeal to Ksitigarbha for salvation.