In the American Indian Theme series, Lichtenstein rearranges elements derived from three-dimensional objects associated with Native American culture. These compositions were influenced, in part, by Lichtenstein's experiences in Southampton during the late 1970s, where he and his wife lived near a Shinnecock Indian reservation. The American Indian Theme series amalgamates loose references to indigenous artifacts like totem poles, textiles, beadwork, quillwork, ceramics, and baskets, blending them with a visual style inspired by contemporary printed materials. This amalgamation bridges two seemingly disparate facets of American culture.

Except for one woodcut in 1970 titled Modern Head #1, the American Indian Theme series represents Roy Lichtenstein's return to using the medium of woodcut since the 1950s. This series, initiated in the spring of 1979, revisits a subject Lichtenstein explored in his earlier career—depictions of the American Indian, infused with surrealist elements. The six prints in this series closely correlate with the ten American Indian/Surrealist paintings he created during the same year. Each print in the series is produced from hand-carved blocks, with American Indian Theme IV incorporating lithography for the white background.

Lichtenstein may have drawn additional inspiration from the collections of his artist friends, including Jasper Johns, Frank Stella, and Donald Judd, who were known to acquire Native American blankets for their own artistic endeavors. During the creation of this print, Lichtenstein was experimenting with novel combinations of motifs, departing from his previous artistic approaches.