The history of Our Lady of Piat dates back to 1604 when a black image of the Virgin Mary with the infant Jesus on her left arm was brought to the Philippines from Macau by the Dominican friars.

During the feast of St. Stephen on December 26, 1623, the image of Our Lady was solemnly brought to the Ermita from Piat with the people following in devout procession.

[4] The following day, the Ermita was blessed and a very solemn Mass was officiated by the deacon with an attendance of more than 10,000 people ("pasaban de diez mil personas") who came from all the neighboring towns.

[4] The priest noted that, it was amazing that such a large multitude would have gathered there, considering that the area was not thickly populated, and that the work of evangelization had been going on for only 25 years.

[4] For this purpose, she decided to open up a new field (sementera) and built a house near the shrine so she and her servants could visit the sacred place often.

[3] Week-long special prayers and services were also held in 29 parishes in the province, a Marian choral contest at the St. Paul University Philippines in Tuguegarao, medical mission, grand procession of all the images of patron saints and the Our Lady, and a cultural show on the documented miracles of the Virgin of Piat.

This pilgrimage site attracts a large number of devotees especially from June 23 to 39 when the Sambali Festival is celebrated and July 1 and 2 for the feast of Our Lady of Piat.

At the back of the church is a staircase that leads to a window located behind the case of the Virgin Mary wherein devotees can touch the dress of Our Lady.

Also surrounding the sanctuary are blessing sites for religious items, the parish convent and life-sized representations of the Stations of the Cross.