The image, one of the oldest in the country, is credited with many miracles including the end of a drought that threatened famine in the Itawes homeland of the Cagayan Valley where the shrine is located.

The image was originally named Nuestra Señora del Santísimo Rosario (Our Lady of the Most Holy Rosary) by the Order of Preachers or Dominicans.

The Ibanag today call her Yena Tam Ngamin ("Mother of Us All"), while to Ilocano-speaking natives of Piat she is known as Apo Baket ("Venerable Matriarch") – a title also used for several images of the Virgin enshrined throughout northern Luzon.

From Manila she was taken to Nueva Segovia (now Lal-lo) to aid in the evangelization of the Itawes homeland, covering the towns of Tabang, Malaweg, Tuau (now Tuao) and Piat, where it stayed for five years.

For the first time, care of the sanctuary was charged to Doña Ines Maquillabbun, who introduced the current custom of keeping a votive light burning perpetually before the icon.

Their deeply rooted devotion to Our Lady prompted them to move her sanctuary near the riverbank in the hope that she would spare them from the scourges of the yearly inundations.

In 1730, Captain José Ramos, a Spanish officer assigned in Lallo, fell seriously ill. All efforts by his physicians failed, so he went on a pilgrimage to Piat to seek Our Lady's help.

He made the trip with great difficulty but, upon arriving in Piat, his illness worsened and the parish priest gave him the Last Rites.

However, he did not lose hope and continued to pray to Our Lady of Piat; after a few days he slowly recovered; within a week he got well enough and went to Lallo to resume his duties.

[citation needed] Also attributed to the intercession of Our Lady of Piat is the miraculous recovery from serious illness of Doña Ines Maquilabbun, the icon's first appointed camarera or caretaker.

The vicars preached fervent sermons to the people, insisting on the need to "repent from their sins and receive the Sacrament of Reconciliation," so that their prayers for rain would be heard.

The people followed the priests' exhortations with great devotion, spending the whole day in the Ermita to confess their sins and sing hymns to the Virgin.

The procession was held in thanksgiving to Our Lady of Piat for the rain which continued uninterrupted for three days, resulting in an abundant crop.

When, eventually, the river went back to its normal course, the Ermita was so dried, clean and tidy that no one could say any rain had fallen or flooding had occurred in the vicinity.

All this happened to the great surprise of the caretaker or "ermitaño" who, afraid for his life, had climbed to the altar of Our Lady and, on his knees, prayed for his safety.

Romano's account involves the young son of Alferez Don Pedro León y Labuag, a resident of Lallo, who was covered with a very repulsive leprosy so that he was not allowed to touch anybody for fear of contamination.

[citation needed] Arieta Legasto, a 77-year-old woman from New Manila in Quezon City, reported her healing from pleurisy through Our Lady of Piat's intercession.

At this time, her friend, Carmeling Crisólogo – a devotee of Our Lady of Piat – visited her and gave her a copy of the image's novena rite and a vial of blessed oil.

This pilgrimage site attracts a large number of devotees especially on July 1 and 2 when the feast of Nuestra Señora de Piat is celebrated.

The arch bears the phrase, "Basilica Minore Nuestra Señora de Piat"(Minor Basilica of Our Lady of Piat), and "Dios Nikaw ti Maria" on its left pillar and "Nappanu ka ti grasya" on its right pillar which translates to "Hail Mary full of grace".

Surrounding the basilica stands the Adoration Chapel, St. Dominic de Guzman Church, Religious Goods Store and Basilica Office, the Baptistry, the Rosary Garden which contains the life-sized images of the Stations of the Cross and the images of the 12 Apostles, and an area for placing votive candles and the Church Convent.

In April 2005, the Bukál ng Buhay ("Spring of Life") began to draw devotees after a woman dreamt of Our Lady of Piat while working abroad.

[7] Activities include novenas, beauty pageant, sports tournaments, Lakbay Yaman Industry Tours, street dancing and the famous cultural presentations by indigenous groups.