The altarpiece depicts a somewhat aloof Madonna, dressed in a bright blue robe, sits on a gilded chair, with the child Jesus each dropping rosaries to their intermediaries: the Dominican saints Dominic (founder of order) and Catherine of Siena.

Catherine, holding a Lily and an early follower of Dominic, also stands and receives the rosary from a child Jesus.

Rosalia, one of the female patron saints of Palermo, lived in paleochristian era, hence never a Dominican nun.

To the right of Catherine, with a gilded sun on his chest, is Thomas Aquinas, one of the Doctors of the church and also a Dominican friar.

An etched mirror copy of this painting by the Flemish artist Robert van Audenaerde (1663–1743) is owned by the National Gallery of Scotland, where it is described as Madonna of the Rosary with Saints Thomas Aquinas, Rosalia, Catherine of Siena, Dominic and Oliva.