She derives from the Aztec goddess of death Mictecacihuatl, dressed in the style of women of medieval Europe, like the statues of the saints of the Catholic religion. 
The Santa Muerte generally appears as a skeletal female figure, dressed in a long robe holding one or more objects, usually a scythe and a globe . Her dress can be of various colors, since the images of the figure vary widely from devotee to devotee and according to the function of the rite that is bestowed on her.
Since the cult of the Santa Muerte was clandestine until the 20th century, most prayers and other rites have traditionally been celebrated privately . Since the beginning of the 21st century, especially in Mexico City, new religious organizations have sprung up, thus making this cult public .