Because his name is missing from all of these kings lists, many presume that he may have usurped the throne. His mother was a commoner with no royal titles other than "king's mother', so it is possible that he may not even have been a member of the royal family. We know virtually nothing about any other of his family members. It should also be noted that inscriptions from the Hatnub travertine quarry suggest that some of the nomarchs (provinces) in Middle Egypt might have been troublesome at about this time.

We should also note that the temple on the West Bank at Thebes cupped in a spectacular amphitheater of cliffs just a short walk from the mortuary temple of Queen Hatshepsut, which has traditionally been ascribed to Amenemhet I, is now believed by some scholars to be attributable to Mentuhotep IV. If so, this would be about the only building established by this king.

This is a shadowy king and records regarding his reign are rare. From the reign of Amenemhet I, we find a fragment of a slate bowl discovered at Lisht in the first nome with both the name of Nebtawyre Mentuhotep and Amenemhet I. However, we do know that a vizier under Mentuhotep IV was one Amenemhet, who is well attested from a long inscription that he left in the Wadi Hammamat, He acted as Governor of the South under Mentuhotep IV, and most Egyptologists seem to believe that he is one and the same as King Amenemhet. 

As vizier to Mentuhotep IV, he records that he went with an army of 10,000 (some sources say 1,000) men into the Wadi to seek and retrieve a fine flock of stone suitable for the lid of the king's sarcophagus. The text says that they were led to the block by a pregnant gazelle which, having dropped its young on to the stone to mark it, was immediately sacrificed on the block. A second miraculous event was also recorded when, after a ferocious rainstorm at Wadi Hammamat, a well 10 cubits square was revealed that was full of water to the brim. In such barren terrain, this would certainly have been a spectacular discovery. 

Apparently, the block was successfully detached from the surrounding rock and safely taken to Thebes. However, during their expedition, they were also charged with finding a more favorable port on the Red Sea. Apparently, the port they found was Mersa Gawasis (Kuser), which was not established until the reign of Amenemhet II as the embarkation point for expeditions to Punt. 

Regrettably, one of the reasons this king remains so obscure is that his tomb, and the sarcophagus made from the block as well as his mummy, has never been found. Perhaps Mentuhotep IV was never able to use the stone since it appears that Amenemhet, with the backing of his 10,000 (or 1,000) men, overthrew his master and proclaimed himself king, founding the 12th Dynasty. It has been suggested by Richard Tidyman tht the name of the new capital, Lisht, was a direct reference to this event, and that the literary texts known as the Prophecy of Neferti and the Instruction of Amenemhat I should be considered in the light of evidence for a civil war accompanying the takeover. However, there is really no direct evidence of such revolt and it is also possible that Mentuhotep IV simply died without an heir.

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