The parish church of San Pietro in Pitigliano was made a collegiate church in 1509, and then refurbished under count Niccola III degli Orsini, when the dedication was changed to Saints Peter and Paul (Santi Pietro e Paolo).
The see was renamed once more on 30 June 1986, moving Pitigliano to the first position in the present diocesan title: Diocese of Pitigliano–Sovana–Orbetello.
The cathedral has an altarpiece in the choir, depicting the Enthroned Madonna with Saints Peter and Francis (1494) by Guidoccio Cozzarelli.
In addition, in 1885, Pietro Aldi painted two large canvases, Henry IV at Canossa and the Life of Ildeprando in Sovana.
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