Serket was worshipped before the first pharaohs united the Two Lands, her cult rooted in the Predynastic period when Egypt was still a patchwork of villages scattered through the marshes and reed beds of the delta. The scorpion was everywhere in those early centuries, hiding in the cracks of mud-brick walls, beneath the mats of sleeping children, and among the reeds where women gathered papyrus. Its sting brought burning pain, paralysis of the throat, and death to the young and the old, and the Egyptians learned quickly that the creature that could kill could also be prayed to for protection. Serket's very name, srqt, was a promise: she who makes the throat breathe again, she who reverses the suffocation that venom brings. Amulets bearing her image were worn by mothers and hung above cradles, and physicians trained in her cult recited spells that called her power down upon the stung and the bitten.

By the time of the Old Kingdom, Serket had become one of the most important protectors of the royal house. In the Pyramid Texts, the earliest religious writings ever carved, she appears as the divine nurse who suckles the king and guards his path to the afterlife. One protective spell reads: "My mother is Isis, my nurse is Nephthys, Neith is behind me, and Serket is before me." These four goddesses - Isis, the goddess of magic and motherhood; Nephthys, the goddess of protection and mourning; Neith, the primordial weaver and warrior of Sais; and Serket - formed the eternal guard around the pharaoh, and their images would one day be carved in gold upon the canopic chest of Tutankhamun. Serket's particular charge was Qebehsenuef, the falcon-headed son of Horus who watched over the intestines of the deceased, and she earned the title "Mistress of the Beautiful House," the embalming pavilion where the dead were prepared for eternity. The intestines were associated with poison in Egyptian thought, and so the goddess of venom was given dominion over the organ most vulnerable to it.

The most famous myth of Serket is the tale of the seven scorpions, recorded in magical texts from the New Kingdom. When Isis fled into the marshes of the delta to hide her infant son Horus from Set, the red-haired god of chaos who had murdered Osiris, the god of fertility and resurrection, and scattered his body across Egypt, Serket sent seven of her scorpions to serve as bodyguards for the mother and child. These scorpions walked before Isis as she travelled by night, their tails raised and ready, and when a rich woman refused the goddess shelter, the scorpions crept into her house and stung her son. Isis, hearing the woman's cries, returned and healed the child with her magic, and the scorpions withdrew. The story taught that Serket's creatures answered to mercy as well as to command, and that the goddess who sent venom could also send its cure. In another version of the tale, it is Serket herself who presides over the difficult birth of Horus, keeping snakes and scorpions at bay while Isis labours in the reeds.

In the Middle Kingdom, Serket's role expanded into the underworld itself. The Book of the Two Ways, a guide to the afterlife painted upon the coffins of the Middle Kingdom, describes her standing guard at a dangerous twist in the path that leads to the Field of Reeds, the Egyptian paradise. She binds and contains the serpent Apep, the demon of chaos who attacks the sun god Ra's bark each night as it sails through the twelve hours of darkness, and she watches over the dangerous turns in the route that every soul must travel. In the New Kingdom she was given the title "Serket the Great, the Divine Mother," and she appears in the birth scenes of Amenhotep III at Luxor Temple and in the mortuary temple of Hatshepsut, the female pharaoh of the Eighteenth Dynasty, where she stands with Neith beside the divine marriage bed of Amun and the queen. She was identified so closely with Isis that the two eventually merged, and in the Late Period Serket was often considered merely an aspect of the greater goddess, her independent cult absorbed into the dominant worship of the mother of Horus.

The most enduring image of Serket is the golden statue discovered in the tomb of Tutankhamun in 1922. She kneels upon one of the four corners of the gilded shrine that protected the king's canopic chest, her arms outstretched in the gesture of protection, a scorpion upon her head with its tail raised but its stinger absent, a symbol of her benevolent power. The statue is barely thirty centimetres tall, but it captures the essence of the goddess who has guarded the dead for six millennia. No temples were ever built solely in her honour, yet her name was invoked in every healing spell, every birth ritual, and every funeral across the length of Egyptian history. In January 2025, archaeologists discovered the tomb of a chief palace physician at Saqqara who bore the title "director of medicinal plants and conjurer of the goddess Serket," proof that her power was still recognised four thousand years after her first invocation.