The king was a huge sahuagin, towering over all his citizens and even elite guards. He believed that typical humanoids, such as humans, elves and half-orcs were funny looking scaleless creatures with odd skin colors. The massive creature had the strength of a fire giant. Like his father before him, he executed many of his own kind, making others believe him mad.
He also kept the key to the treasury of the City of Caverns on his person, and owned a magical rope that could allow the user to ascend or descend any height.
Ixilthetocal ruled the City of Caverns. However around 1369 DR, Prince Villynaty started a civil war in order to dethrone Ixilthetocal. Gorion's Ward and their adventuring party may have arrived in the City of Caverns where Ixilthetocal met them, asking them to kill Villynaty. The rebel was plotting against the king at this time, but Ixilthetocal was supported by several soldiers and some members of royalty, such as Baron Thelokassyil.