The construction was begun in the 15th century on the site of two pre-existing Romanesque, "twin" cathedrals (Santo Stefano and Santa Maria del Popolo).

[4]The cathedral was begun in 1488, under architect Cristoforo Rocchi, who was soon replaced by Giovanni Antonio Amadeo and Gian Giacomo Dolcebuono.

The original project, with a nave and two aisles flanked by semicircular niches and a large central dome, was influenced by Bramante, some details of it later appearing in St. Peter's Basilica in Rome.

[1] In particular, the planimetric project, the design of the crypt (completed in 1492), of the base part of the apse area of the building and of the sacristies are attributed to Bramante.

The large pillars, which support lowered vaults, and the pointed arches of the central nave recall the thermal rooms of the classical age and the nymphaeums, such as that of the Horti Sallustiani in Rome.

In 1930, construction continued with the two arms of the transept, for which the original plan was followed, although using reinforced concrete (in order to save the remains of the medieval Santa Maria del Popolo).

The interior, with pure Renaissance architectural lines, gives an impression of great grandeur, amplified by the brightness of the very white marble cladding.

The structure depicts a radiant cave with golden clouds in the center of which two angels hold up a large crown of thorns.

In the apse of the left transept, in the center, the Altar of the Confraternity of suffrage, built by the Genoese Tommaso Orsolino in 1644-46 and remodeled in 1652 with the addition of two columns and other elements of precious marble.

At the foot of the Virgin you can see the outline of the city of Pavia, while on the architrave there is the inscription Fecit mihi magna qui potens est.