It was especially popular in Italy from the 13th to 16th centuries, often as a specialised form of votive portrait; it is also found in other countries and later art, especially Spain and Latin America.

A miniature of c. 1274 from the Armenian Kingdom of Cilicia also shows a variant of the motif, as do 13th century paintings in Cyprus, such as an icon in the Byzantine Museum in the Archbishop's Palace, Nicosia.

[4] Beyond that, the origins of the image may relate to rituals and a vision or miracle connected with a famous icon in the Blachernae Church in Constantinople.

In the Pokrov icons the thought is similar, but the image is usually less literal – the veil with which the Virgin protects mankind is small and held either in her hands or by two angels,[6] though the Western version with a larger cloak is found in some Eastern Orthodox icons, one of a number of Western iconographic features that influenced Orthodox art, whether in Cyprus under the Crusaders[7] or 16th-century Eastern Europe.

In Germany during the Middle Ages, an almost identical image was used featuring Saint Ursula, usually holding her attribute of an arrow to avoid confusion.

The Virgin of Mercy is patron saint of Barcelona, celebrated in the week-long La Mercè festival each year, but in this role is not especially associated with this type of image.