The sand is held in the hand and allowed to fall freely through the thumb and forefinger onto the soil, a cloth or on a board in a pattern. The image is always created from the center outward with the top oriented toward the east. The artist avoids damaging the first created elements of the art by drawing from the center outward. The images represent spiritual beings beings and animals which are always are drawn from the feet upward.
The principle colors used in sand paintings by the Navajo of Arizona are blue, black, white and yellow. The colors symbolize the four directions and four powers. Black is north where rain clouds form. White represents the dawn and east where the Sun rises. Yellow is the west and evening. Blue is midday and the south. Natural materials used to create the colored sands include charcoal, yellow and white sandstone.
The Navajo of Arizona employ the art of sand painting as part of a naturalistic form of healing. Prior to creating a sand painting a Navajo medicine man undergoes a three days of fasting and meditation called a "purification period." The medicine man uses the purification period to prepare himself spiritually and gather necessary supplies to create the sand painting. After this period, the medicine man create the painting during a special healing ritual.
Navajo sand paintings are part of a thriving tourism business in Arizona. Some retail locations in Arizona depend almost entirely on the sale of Navajo sand paintings and other authentic art. Original sand paintings may have been first offered for sale to Arizona tourists sometime in the early 1950s. Sand paintings are created on a board covered with an adhesive to fix the sand. Some Navajo intentionally create paintings with incorrect symbolism to preserve the sacred nature of the genuine works.