His work primarily deals with birth and motherhood. Traced back to the 11th century, the Sheela Na Gig, a depiction of a figure pulling open an exaggerated vulva, was possibly a symbol for fertility worship, or a symbol to stray off evil or a warning against lust. Sansuna, also a mother figure, is the heroic giantess who carried megaliths across the island of Gozo, building the Ġgantija Temples in 3600 BC. Carrying her half-human, half-giant children on her shoulder and balancing a slab of stone on her head, she constructed this temple complex to evoke fertility and rain. Buttiġieġ merges illustrations of Sheela and Sansuna, with imagery of primitive symbolism, vivid language, and visuals related to video games and films, which have brought the artist back to his childhood and early days of drawing.