Now a museum, it was once an important civic hospital dedicated to caring for abandoned children, the poor, the sick, and pilgrims.

[1] Siena lies on the Via Francigena, the main pilgrimage road to Rome, and the Hospital was probably founded to accommodate the pilgrims and other travelers who passed through by the canons of the Duomo.

[1] To settle infighting between the clergy and laypeople over who held more authority, Pope Celestine III issued a papal bull in 1193 that declared the Hospital a lay organization independent of the Cathedral.

[1] In 1359, the Hospital acquired several new relics, including part of the Virgin Mary's girdle and her veil, possibly to stimulate pilgrim travel.

[3][6] At the end of the 13th century, the Hospital sped up its physical expansion and internally began splitting up according to the different functions it held (such as headquarters for confraternities, caring for the sick, sheltering pilgrims, etc.).

[citation needed] In 1404 the Council of Siena took control of the rector nomination process and made it a city office.

[1] In the 1430s, the confraternity devoted to Saint Jerome moved into the rooms in the lower levels of the Hospital, which were directly accessible from the streets.

[2] In the 1330s Santa Maria della Scala commissioned many important interior and exterior frescoes as well as several significant, later altar pieces such as Beccafumi's Trinity Triptych of 1513.

Due to well-kept documents, the artists who created these magnificent frescos can be identified as Simone Martini and the Lorenzetti brothers, Pietro and Ambrogio.

[7] The church has a series of frescoes depicting the Life of the Virgin (1398):[7] These scenes where chosen to not only honor Mary, but to give recognition to her parents, Saints Joachim and Anne, the subjects of the special devotion at the Hospital during the 1320s and 1330s.

[8] These scenes are among the first known works depicting the early life of the Virgin, and, like Giotto's fresco of this subject in the Arena Chapel in Padua (completed 1305), became a valuable model for iconography.

[9] Due to records, it is known both Pietro and Ambrogio signed and dated the works on the façade of Santa Maria della Scala in 1335.

Simone Martini and the Lorenzetti brothers were among the most talented painters in Sienese art during this time, and led large studios.

[7] Commissioned in 1448 for the Capella dei Signore in the Palazzo Publico, Sano di Pietro's panel contains the same scenes as those painted in the facade for the Ospedale.

[9] The altarpieces that adorned the interior of Santa Maria della Scala also centered on the life of the Virgin Mary.

Some of the places of interest a museum-goer today can explore are the Pellegrinaio, the Cappella del Manto (Chapel of the Mantle), the Sagrestia Vecchia (Old Sacristy), the Cappella della Madonna (Chapel of the Virgin Mary), and the Oratories of the Compagnia di Santa Caterina della Notte and of Santa Maria sotto le colte.

The ravaged sculptures by Jacopo della Quercia from the Fonte Gaia are displayed here, as well as drawings and models for the 1858 restoration.