Traditional Navajo religion teaches that all of life is inter-connected, from the smallest leaf to the biggest thunderstorm.  Life is lived in a precarious balance between many different elements and forces.  If any of these is out of balance, then some trouble such as illness may ensue.  Illness can be physical, mental, emotional or spiritual.  Part of the process of returning life to balance is an elaborate healing ritual performed by Navajo medicine men, which includes numerous stages for the afflicted party.  After a diviner, often a woman, has determined what is wrong and the probable cause, the medicine men begin their work.  They consecrate the hogan (dwelling), lay out sacred materials from medicine bundles, prepare a special bath for the patient and begin a long process of sandpainting on the ground and chanting.  The medicine man may apprentice for many years just to learn one sandpainting and corresponding chant.  This ceremony may go on for part of a day, or up to nine days, depending on the specific ailment and what is required to remove it.  If everything is done properly, then the yeíis (powerful Navajo spiritual beings) must fulfill their part and come into the hogan and heal the patient.

The art of Navajo sandpainting comes from this healing tradition.  Many of the themes in sandpaintings that are made for collectors come from stories and legends that shape Navajo religion.  Often the stories concern a hero who goes on a long journey, experiences extreme challenges, and returns to the tribe with ceremonial knowledges.  Yeíis figure prominently in most sandpaintings.  Generally females are shown with square or rectangular heads, and males with round or oval heads.  Guardian figures such as rainbows are also frequently used to protect the one making the painting, and also the final piece.  Themes showing the sun and moon, thunder, and winds are also common.  Many of the powerful forces in nature find their way into sandpaintings.  Mother Earth and Father Sky are another favorite pair, showing the female and male elements in nature.

Artists use simple particle board or wooden surfaces which they paint with glue.  Each layer of colored sand is adhered separately, then another layer of glue is applied and more sand is sprinkled on with the fingers.  It is a painstaking, creative process. The art form often alters ceremonial sandpaintings in subtle ways, as the ones done on the ground for religious purposes are destroyed, and the artist does not want to offend the yeíis by presenting an exact replica.  Sandpainters also make changes to create original works of their own.  But the themes remain the same, and are a part of a living religion and culture.