Despite the title, the book has nothing to do with the Maccabees or their revolt against the Seleucid Empire, as described in 1 Maccabees and 2 Maccabees. Instead it tells the story of persecution of the Jews under Ptolemy IV Philopator (222–205 BC), some decades before the Maccabee uprising. The name of the book apparently comes from the similarities between this book and the stories of the martyrdom of Eleazar and the Maccabeean youths in 2 Maccabees; the High Priest Shimon is also mentioned.

The contents of the book have a legendary character, which scholars have not been able to tie to proven historical events, and it has all the appearances of a romance. According to the book, after Ptolemy’s defeat of Antiochus III in 217 BC at the battle of Raphia, he visited Jerusalem and the Second Temple. However, he is miraculously prevented from entering the building. This leads him to hate the Jews and upon his return to Alexandria, he rounds up all the Jews in the kingdom to put them to death in his hippodrome. Those Jews who agree to abandon their faith are to be spared.

An attempt to register all the Jews before their execution is thwarted by the sheer number of the Jews. Ptolemy then attempts to have the Jews killed by crushing by elephant and orders 500 elephants to be intoxicated in order to enrage them. However, the execution is repeatedly thwarted, as God first causes Ptolemy to oversleep, then causes him to miraculously forget his anger against the Jews. Ptolemy finally attempts to lead the elephants and his own army into the hippodrome to destroy the Jews personally, but after an impassioned prayer by Eleazar, God sends two angels who prevent this.

Ptolemy abruptly forgets his anger with the Jews and honours them with various immunities and a banquet, with several dates being established as commemorative festivals. The Jews request and receive permission to return home and to kill all the Jews who chose to abandon their faith in order to be spared. The book includes a letter, ostensibly by Ptolemy, to this effect. Finally, the Jews return home.