Al Jaffee, a cartoonist who folded in when the trend in magazine publishing was to fold out, thereby creating one of Mad magazine’s most recognizable and enduring features, died on Monday in Manhattan. He was 102.

His death, at a hospital, was caused by multi-system organ failure, his granddaughter Fani Thomson said.

It was in 1964 that Mr. Jaffee created the Mad Fold-In, an illustration-with-text feature on the inside of the magazine’s back cover that seemed at first glance to deliver a straightforward message. When the page was folded in thirds, however, both illustration and text were transformed into something entirely different and unexpected, often with a liberal-leaning or authority-defying message.

For instance, the fold-in from the November 2001 issue asked, “What mind-altering experience is leaving more and more people out of touch with reality?” The unfolded illustration showed a crowd of people popping and snorting various substances. But when folded, the image transformed into the Fox News anchor desk.

The first fold-in, in the April 1964 issue (No. 86), mocked Elizabeth Taylor’s marital record. (Unfolded, she is with Richard Burton; folded, she has traded him in for another guy.) No one, especially Mr. Jaffee, expected that fold-in to be followed by hundreds more.

“It was supposed to be really a one-shot,” he said in a 1993 interview with The Kansas City Star. “But because of the overwhelming demand of three or four of my relatives, it went on to a second time, and on and on.”

That “on and on” turned into a career that included other memorable contributions to Mad, like a “Snappy Answers to Stupid Questions” feature, and that in 2007 won him cartooning’s top honor, the Reuben Award, putting him in the company of Charles M. Schulz, Mort Walker, Gary Larson, Matt Groening and other luminaries of the trade.