There was probably a palaeochristian church on the site, as a chapel was founded around the tomb of Saint Felix of Nola, a martyred bishop of the region.
It was reconstructed in a Gothic style in the 1370s under the patronage of Count Niccolò Orsini and was consecrated to "the Blessed Virgin and the Saints Felix of Nola and Paulinus" (Felice Martire e Paolino).
It was rebuilt over the centuries, particularly in 1583, and in 1861 after a serious fire; on the last occasion it was reconstructed in a Neoclassical style.
Among the artists and architects involved were Nicola Breglia, Salvatore Cepparullo and Paolo Vetri.
With the reconsecration, the relics of Saint Felix were brought back to the cathedral.