Mary carries this title from Scripture itself. In Genesis 3:15, God promises enmity between the serpent and the woman, and the Douay-Rheims says it plainly: "she shall crush thy head." As Mother of God and Queen of Heaven, her "yes" to God undid the disobedience of Eden, and the serpent lies defeated beneath her feet.
The front carries her royal crown, topped with the cross, above the words Crusher of Serpents. The back carries a full illustration of Mother Mary crowned, rosaries in hand, standing on the serpent. It's a reminder of her protection, worn close.