The Buffalo Mask, from the Buffalo prehistoric site in Putnam County, is one of the most famous examples of engraved marine shell gorgets found in West Virginia. Marine shell gorgets were produced throughout the Southeast from about A.D. 1000 until the 1600s. Many found their way into neighboring regions through trade or intermarriage. In West Virginia, more than 60 marine shell gorgets have been found at late prehistoric or near-historic villages of the Fort Ancient culture.

A gorget is an ornament of stone, shell, or metal strung on a leather cord and hung around the neck or gorge. Most marine shell gorgets were made from whelk shells found only along the Gulf and Atlantic coasts. A shell was cut into the rough form, the edges smoothed, and the surface engraved. Mask gorgets, bearing the features of a face, were always engraved on the convex, outer surface of the shell, while round gorgets were engraved on the concave, inner surface.

Many styles of gorgets were made throughout the Southeast. Most of the designs found on marine shell gorgets reflect elements in the mythology of historic Indian groups such as the Creek, Choctaw, and Cherokee. In West Virginia, the most commonly found styles are the mask gorget and the round rattlesnake gorget. The rattlesnake gorget was traditionally associated with women and children. Mask gorgets were traditionally associated with males and children. The "weeping eye" motif found on some mask gorgets is thought to represent tears, or the markings of a bird of prey, or Thunderbird.