With the fall of Acre in 1291, the Knights of Saint Lazarus emigrated from the Holy Land and Egypt and settled in France and, in 1311, in Naples.

During medieval times, the Order of Saint Lazarus maintained a number of hospitals, including an institution in the Italian city of Capua.

In 1572, Pope Gregory XIII united the Order of Saint Lazarus in perpetuity with the Crown of Savoy.

The pope gave him authority over the vacant commanderies everywhere, except in the states of the King of Spain, I. e. the Kingdoms of Naples, Sicily and Sardinia and the Duchy of Milan.

The war galleys of the order fought against the Ottoman Empire and the Barbary pirates with the United States Marine Corps.

In 1831, under Charles Albert of Sardinia the order was opened specifically for members of the upcoming bourgeoisie.

[6] The House of Savoy in exile continues to bestow the order on recipients eminent in the public service, science, art, letters, trade, and charitable works.

While the continued use of those decorations conferred prior to 1951 is permitted in Italy, the crowns on the ribbons issued before 1946 must be substituted for as many five-pointed stars on military uniforms.

Both Knights of Justice and of Grace had to vow obedience to the Grand Master, chastity at least outside marriage (castità almeno conjugale, which meant they could marry with papal placet) and help towards the sick and poor.

In 1831, Charles Albert of Sardinia made the vow of the Knights of Grace facultative, and in 1851 the category of Justice was abolished by Victor Emmanuel II.

The Junta is responsible for voting in new Knight or Dame to the dynastic order on behalf of the grand master, Emanuele Filiberto, Prince of Venice.