The lady is derived from Nuestra Senora de la Santa Muerte, or Our Lady of the Holy Death.  Also known as La Huesada, the Bony Lady.  Santa Muerte is a venerated folk saint in Mexico and the Southwestern portion of the United States.

She is representative of death, healing, protection and a safe journey to the afterlife.  She is a cartel favorite often displayed on dashboards and body pictorials.