The term Axis of Medieval was coined by activists as a parody of the phrase "Axis of Evil." Critics of the policies of George W. Bush use the term, half jokingly, to describe efforts used by the United States to insert a "conservative" political agenda into negotiations to draft international treaties for humanitarian causes.

Political moves seen as encouraging the use of "axis of medieval" have included actions taken in 2002 to cut off $34M in funding for the United Nations Population Fund, due to concerns that some of the money was used to fund abortions. On this issue, the United States became an ally of fundamentalist Islamic regimes in countries such as Iran and Syria, united in opposition to the majority of Western countries, who favoured the liberal point of view.

The phrase has also been used in reference to actions by United States politicians, intended to block moves to raise the minimum age for military enlistment from 15 to 18 for child soldiers in the Convention on the Rights of the Child, which the United States currently refuses to ratify.

The phrase is also used in reference to the continued execution of criminals for offenses committed as juveniles. From 1996 to 2002, 17 such criminals have been executed worldwide. Ten of these were in the USA, three in Iran, two in Pakistan, one in Congo and one in Nigeria. Pakistan has since abolished the child death penalty.

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