Ketubah illustrators, mainly in Italy, sought ideas that would enrich the imagery on the marriage document and give it appropriate meaning. This process started with the borrowing of a well-known motif and using it for something new and more fitting.
In the case of Jerusalem, the meaning of the motif on the ketubah was a reference to the traditional custom of elevating the memory of the destruction of the Holy City during special events in the lives of the individual and the community.
During the 17th century a large medallion held by two allegories began to appear on top panel of the parchment. The medallion contained a picture of the city of Jerusalem seen from a bird's eye view. The city itself is walled and inside the wall there are domes, towers, small houses, hills and a few cypress trees. This depiction of the city is well-known both from general art and from Italian Jewish art. Among the Jews, it was most common in Venice, and appeared on curtains for synagogue arks the 17th century, and in the famous Venice Haggadah, which was first published in 1609.
The change in the ketubot was mostly contextual: above the city wall a ribbon is waving, hinting at the verse: "I will set Jerusalem above my cheifest joy" (Psalms 137: 6). Added here to the commandment to remember the destruction of the city is the tradition "to set Jerusalem above joy", meaning the wedding. Ketubot artists interpreted this tradition literally, drawing Jerusalem at the top of the ketubah.