It is reached via a steeply ascending route which winds through a wooded natural park, whose flora was catalogued by the Casalese photographer and polymath Francesco Negri.
Construction began in 1589 around an existing sanctuary which is dedicated to the Virgin Mary and whose creation is traditionally attributed to Saint Eusebius of Vercelli around 350 AD.
The chapels dedicated to the Mysteries of the Rosary were positioned around the one-thousand-year-old Marian sanctuary on the highest of the hills of Basso Monferrato.
As time passed the initial scheme of the monumental layout was altered on a number of occasions and in 1820 significant restoration work began after its partial destruction.
Since 1980, woods and some agricultural land surrounding the Sacro Monte have been preserved as the Parco naturale del Sacro Monte di Crea, whose area is 34 hectares (84.0 acres) where visitors can admire some plant species no longer widely found elsewhere.