The obelisk was erected during the 18th dynasty by Pharaoh Thutmose III (1479–1425 BCE) to the south of the seventh pylon of the great temple of Karnak. The Roman emperor Constantius II (337–361 CE) had it and another obelisk transported along the river Nile to Alexandria to commemorate his ventennalia or 20 years on the throne in 357 CE. The other obelisk was erected on the spina of the Circus Maximus in Rome in the autumn of that year, and is now known as the Lateran Obelisk.

The obelisk that would become the obelisk of Theodosius remained in Alexandria until 390 CE; when Theodosius I (379–395 CE) had it transported to Constantinople and put up on the spina of the Hippodrome there.

circa 1450 BCE

Obelisk
The Obelisk of Theodosius is of red granite from Aswan and was originally 30 meters tall, like the Lateran Obelisk. The lower part was damaged in antiquity, probably during its transport or re-erection, and so the obelisk is today only 18.54 meters (or 19.6 meters) high, or 25.6 meters if the base is included. Between the four corners of the obelisk and the pedestal are four bronze cubes (inspect), used in its transportation and re-erection.

circa 1450 BCE

Pedestal
The marble pedestal had bas-reliefs dating to the time of the obelisk's re-erection in Constantinople. On one face Theodosius I is shown offering the crown of victory to the winner in the chariot races, framed between arches and Corinthian columns, with happy spectators, musicians and dancers assisting in the ceremony. In the bottom right of this scene is the water organ of Ctesibius and on the left another instrument.

There are obvious traces of major damage to the pedestal and energetic restoration of it. Missing pieces have been replaced, at the pedestal's bottom corners, by cubes of porphyry resting on the bronze cubes already mentioned – the bronze and porphyry cubes are of identical form and dimensions. There is also a vertical gash (inspect) up one of the obelisk's faces, which looks like a canal from above. These repairs to the base may be linked to the cracking of the obelisk itself after its suffering a serious accident (perhaps an earthquake) at an unknown date in antiquity.

circa 1450 BCE

Eastern Facade
The pedestal's east face bears an inscription in five Latin hexameters. This is slightly broken at the bottom but it was transcribed in full by travellers in the 16th century. It reads:
DIFFICILIS QVONDAM DOMINIS PARERE SERENIS
IVSSVS ET EXTINCTIS PALMAM PORTARE TYRANNIS
OMNIA THEODOSIO CEDVNT SVBOLIQVE PERENNI
TER DENIS SIC VICTVS EGO DOMITVSQVE DIEBVS
IVDICE SVB PROCLO SVPERAS ELATVS AD AVRAS

Translation: "Though formerly I opposed resistance, I was ordered to obey the serene masters and to carry their palm, once the tyrants had been overcome. All things yield to Theodosius and to his everlasting descendants. This is true of me too – I was mastered and overcome in three times ten days and raised towards the upper air, under governor Proculus."

circa 1450 BCE

Western Facade
On the west face the same idea is repeated in two elegiac couplets rendered in Byzantine Greek, though this time it reports that the re-erection took 32 days (TPIAKONTA ΔYO, last line) not 30: it reads
KIONA TETPAΠΛEYPON AEI XΘONI KEIMENON AXΘOC
MOYNOC ANACTHCAI ΘEYΔOCIOC BACIΛEYC
TOΛMHCAC ΠPOKΛOC EΠEKEKΛETO KAI TOCOC ECTH
KIΩN HEΛIOIC EN TPIAKONTA ΔYO

Translation: "This column with four sides which lay on the earth, only the emperor Theodosius dared to lift again its burden; Proclos was invited to execute his order; and this great column stood up in 32 days."