A sick farmer, afflicted with a serious palsy according to oral history, was healed after praying to an image of the Virgin Mary painted close to the entrance to his own market garden.

The event led to popular worship for the painting, and subsequently a small votive chapel was erected, soon followed by a greater church, funded by 12 professional associations (Università).

Its façade is largely ascribed to Vignola (though sometimes attributed to Martino Longhi the Elder[4]), while the interior is by Guidetto Guidetti, a pupil of Michelangelo who transformed the former Greek-cross design (with four apses) into a Latin-cross structure with three naves.

The church is still guarded by the Archconfraternity of S. Maria dell'Orto[5] that, due to the seniority of its papal establishment, is the most ancient of the Confraternities consecrated to the Holy Virgin still active in Rome, and one of the first overall.

Due to its position on the margin of the walls, not far from Porta Portese and close to the Port of Ripa Grande, it had great commercial importance, and the church became a reference point for the professional associations involved in the food supply of the town and of the ships from and to Ostia through the Tiber: foodstuffs producers and merchants, as well as brokers and service suppliers.

The event gave rise to the tradition of a sung Mass that is celebrated on 8 June (the anniversary day), with the attendance of delegates from the Japan Embassy in the Holy See and from the Japanese community in Rome (source: Enrico Pucci).

In the evening of Holy Thursday, the monumental Macchina delle Quarant'Ore ("Machine of the Forty Hours") is set up: it is a 19th-century structure based upon a 17th-century design, with floral decorations, made of carved and gilt wood on which more than two hundred candles are placed, so as to illuminate the mystical dark.

During the suggestive ceremony, blessed apples are distributed to the faithful, both in remembrance of the former Fruttaroli ("fruit sellers") guild, that gave a significant contribution to the artistic treasures of the church, and for a devotional reason: the head of the household, during the dinner, will divide the fruit into as many slices as the relatives, to symbolize "the unity into the diversity" of the Mystical Body of the Church, according to St. Paul's teaching (I Cor.

For example, the earthly glory of Mary is depicted on the ground level, along the walls, starting from the Annunciation through all the other episodes of her life (Nativity, Presentation at the Temple, Marriage, Visitation, Flight into Egypt and so on).

The Tower, the Ark, the Door and the Star are attributes that can be found into the Litany of Loreto, while the mottoes above – except Foederis arca – are taken from the verses of the ancient Marian hymn Ave Maris Stella.