Every 3rd of September, a hundred men called "Facchini di Santa Rosa" ('Saint Rose's porters') carry the contraption—weighing about 11,000 pounds (5,000 kg)—and parade it through the streets and squares of Viterbo's medieval town centre, amid festive crowds of devotees and onlookers.

The machine's procession is a significant event in Viterbo, attracting thousands of spectators, and is included in the UNESCO Representative List of the Intangible Cultural Heritage of Humanity.

On the afternoon of 2 September, a reliquary containing the heart of Santa Rosa is carried in procession accompanied by people in period costumes of the 14th through the 19th centuries.

It is possible that originally the inspiration for today's Macchina was a processional statue of St Rose carried on a canopy lit by candles.

Twenty-two people in the crowd died in the ensuing confusion and later that night the machine caught fire in Piazza delle Erbe.

[2] On the occasion of a papal visit by Pope John Paul II, on 27 May 1984, the Macchina was brought out and taken to the piazza in front of the Chapel of Santa Rosa.

[4] On 6 September 2009, Pope Benedict XVI viewed the new Macchina di Santa Rosa Fiore del Cielo in front of the pilgrimage chapel.

The constraption must weigh less than 5 tonnes and measure less than 4.3 metres in width in order to maneuver the narrow streets of the historical centre, where eaves and balconies could strike the carried Macchina.

While originally the towers were mainly made from papier-mâché, today materials such as steel, aluminium and fibreglass are used to achieve a light and fireproof construction.

The Sodality Facchini of Santa Rosa was founded in 1978 to keep alive the age old tradition and ensure it is done in a safe and responsible manner.

To be selected as one of the Facchini is considered a particular honor, and one most pass a test of strength, carrying a 150-kilogram box on his shoulders for at least one hundred meters without stopping.

In order to overcome this slope, the Macchina is pulled by ropes and additional people and is eventually placed in front of the pilgrimage chapel.