The Alphabet of Ben-Sira is an anonymously-authored medieval novel describing the conception, birth, and education of the "prophet" Ben Sira. It is dated anywhere from the seventh to the eleventh century.

The final section of the work takes place in the court of the Babylonian king Nebuchadnezzar. Here, Nebuchadnezzar sets forth various ordeals for Ben Sira. Ben Sira responds with twenty-two stories (mimicking the twenty-two letters of the Hebrew alphabet, thus the name) to answer the questions posed by the king.

One of the most important passages tells the story of Lilith, and it is the fifth of Ben Sira's responses to King Nebuchadnezzar. It is reproduced here in its entirety:

Soon afterward the young son of the king took ill. Said Nebuchadnezzar, "Heal my son. If you don't, I will kill you." Ben Sira immediately sat down and wrote an amulet with the Holy Name, and he inscribed on it the angels in charge of medicine by their names, forms, and images, and by their wings, hands, and feet. Nebuchadnezzar looked at the amulet. "Who are these?" "The angels who are in charge of medicine: Snvi, Snsvi, and Smnglof. After God created Adam, who was alone, He said, 'It is not good for man to be alone' (Genesis 2:18). He then created a woman for Adam, from the earth, as He had created Adam himself, and called her Lilith. Adam and Lilith immediately began to fight. She said, 'I will not lie below,' and he said, 'I will not lie beneath you, but only on top. For you are fit only to be in the bottom position, while I am to be the superior one.' Lilith responded, 'We are equal to each other inasmuch as we were both created from the earth.' But they would not listen to one another. When Lilith saw this, she pronounced the Ineffable Name and flew away into the air. Adam stood in prayer before his Creator: 'Sovereign of the universe!' he said, 'the woman you gave me has run away.' At once, the Holy One, blessed be He, sent these three angels to bring her back.

"Said the Holy One to Adam, 'If she agrees to come back, fine. If not, she must permit one hundred of her children to die every day.' The angels left God and pursued Lilith, whom they overtook in the midst of the sea, in the mighty waters wherein the Egyptians were destined to drown. They told her God's word, but she did not wish to return. The angels said, 'We shall drown you in the sea.'

"'Leave me!' she said. 'I was created only to cause sickness to infants. If the infant is male, I have dominion over him for eight days after his birth, and if female, for twenty days.'

"When the angels heard Lilith's words, they insisted she go back. But she swore to them by the name of the living and eternal God: 'Whenever I see you or your names or your forms in an amulet, I will have no power over that infant.' She also agreed to have one hundred of her children die every day. Accordingly, every day one hundred demons perish, and for the same reason, we write the angels names on the amulets of young children. When Lilith sees their names, she remembers her oath, and the child recovers."