It is in the Diocese of Saint Petersburg [ru] and part of the Alexander Nevsky Lavra, where it is the cathedral church of the monastery complex.

The cathedral remained largely unchanged for much of its existence, its importance highlighted by the rich and valuable furnishings that were donated by the imperial family.

[1] The general plans for the monastery complex had been drawn up by Domenico Trezzini, and construction began on the cathedral in 1719, to a design by architect Leonard Theodor Schwertfeger [ru].

[2][3][6] The cathedral was consecrated by Metropolitan Gabriel on 30 August 1790, the feast day of St Alexander Nevsky, in a ceremony attended by Empress Catherine.

[3] As completed the cathedral is surmounted by a single dome on a high drum, with two double-tiered bell towers on either side of the loggia of the central entrance.

The north and south entrances are surmounted by bas-relief panels sculpted by Fedot Shubin, depicting events from the Old and New Testaments.

[6] The iconostasis is made of marble, with images by Johann Jacob Mettenleiter and Ivan Akimov and bronze detailing by Pierre Agie [ru].

Sculptor Fedot Shubin produced twenty bas-reliefs and statues of saints, while the altarpiece was by Anton Raphael Mengs.

[3][6] In 1794 Catherine II donated several valuable paintings by Peter Paul Rubens (Resurrection of Christ), Anthony van Dyck (Blessing of the Saviour), Jacob Jordaens (Lamentation), Jacopo Bassano, Guercino, Bernardo Strozzi and others from the Hermitage.

[2][6] Various relics and ornamental artefacts were collected in the cathedral, including the silver tomb of Alexander Nevsky, a piece of the Lord's Robe, and the image of the Theotokos of Vladimir.

[3] After the revolution, many of the valuables were removed from the cathedral and placed in museums, part of the state's general confiscation of Russian Orthodox Church property.

[1] Between 13 and 28 July 2017 some 500,000 people visited the cathedral to worship at the relics of Saint Nicholas, which were on loan from their permanent home in Bari.