The graphic image depicts the 23-year-old Elmahdy facing the camera, nude and menstruating over the flag, "IS" painted in bold black letters across her bare chest.
Next to her, another woman, her identity concealed beneath a black hijab, her back to the camera, the letters "OLO" and "IS" emblazoned across her bare bottom, defecates on the flag.
The butt stocks of two rifles border the composition.
According to the Times of Israel, the words "there is no God but Allah" printed on the flag caused most Arab media to avoid publishing the picture.
Elmahdy did not provide any commentary to accompany the photo or offer any explanation for her protests, but media outlets have noted the artist's reputation for standing in opposition to the strict and misogynistic nature of Sharia law.
After her art provoked similar controversy when, in 2011, she posted nude pictures of herself on her blog in protest of Egypt's conservative culture, Elmahdy said her photos "scream against a society of violence, racism, sexism, sexual harassment and hypocrisy."
And while Elmadhy has not yet offered any statement on her most recent images, the New York Times reported this statement accompanying some of her earlier work protesting conservative Islam:
"Try nude models who worked in Fine Art Faculties in the early 1970s, hide all art books and smash naked archaeological statues. Then take off your clothes and look at yourselves in the mirror, then burn your body that you so despise to get rid of your sexual complexes forever, before subjecting me to your bigoted insults or denying my freedom of expression."
According to Jezebel, Emad Gad, a parliamentary candidate from the Egyptian Social Democratic Party said of her 2011 protest photos: "Many movements in Egypt, particularly Islamist movements, are trying to benefit. They say, 'We have to protect our society from things like this, and if the liberals win then this woman will become a model for all Egyptian women.'"
Elmahdy's photo appears to have been removed from Facebook, but the original -- extremely graphic -- art was quickly proliferated online and can be seen at Bare Naked Islam.