Old Saint Joseph's had started as a chapel in a residence because public celebration of Catholic Mass was illegal at the time.

Among them were George Washington and John Adams, who observed that the visual and musical splendor of the church encompassed "everything that can lay hold of eye, ear, and imagination, everywhere which can charm and bewitch the simple and ignorant," adding, "I wonder how Luther ever broke the spell.

"[5] In 1810, after Philadelphia had been made a diocese, St. Mary's was named the cathedral, a role in which it continued until 1838, when St. John the Evangelist Church superseded it.

The ceiling features a fresco of Mary's Assumption and stained glass windows, some reaching a height of two stories.

Its cemetery was enlarged by adding an extra layer of soil to the ground level following the Yellow Fever Epidemic of 1793.