It is a representation of the Biblical parable from the Gospel of Matthew 15:14: "Let them alone: they be blind leaders of the blind. And if the blind lead the blind, both shall fall into the ditch."
In this case, Bruegel's depiction is very literal, as the leader of a procession of six blind men has fallen into a ditch and seems sure to drag his fellows down with him.
This piece is widely considered a masterwork for its acute attention to detail and deliberate diagonal composition, which emphasises the confusion and loss of balance of the blind men. It is also an archetypal Bruegel piece as it depicts both a bible verse and subjects with disabilities.
In this piece the blind men are affected by a variety of afflictions, such as ocular globe atrophy, removed eyes and corneal leukoma.
Though, unlike many of his other late works, The Blind Leading the Blind does not include peasants, the sombre colour palette and subject matter is in keeping with this period in the lead up to Bruegel's death in 1569.
Bruegel's son, Pieter Bruegel the Younger, later produced a larger copy of this painting, as he did many of his father's works.
It has also been alluded to by poets, including Charles Baudelaire and William Carlos Williams, and in the novel The Parable of the Blind by German author Gert Hoffman. The piece is now owned by the Museo di Capodimonte in Naples.