Six shepherds, an ass and a cow watch from behind, with a grey-bearded Joseph – depicted in a bright red robe, contrasting with Mary's traditional garb of deep blue – standing behind a column to the left.

A bird – symbolising the Holy Spirit – hovers above, while the Star of Bethlehem shines brightly at the top of the painting.

The paint was applied to a ground of chalk fixed with animal glue, with a thin priming layer of lead white mixed with a little lead-tin-yellow.

It takes its main inspiration from the Monforte altarpiece by Hugo van der Goes (Gemäldegalerie, Staatliche Museen, Berlin), which has a similar grouping of richly dressed Mary and Magi among ruined architecture, with their attendants and bystanders, and glimpses of the landscape behind and angels above.

Lorne Campbell argues that the painting was commissioned by Daniel van Boechout, Lord of Boerlare and Beverweerd, as the altarpiece of the Lady Chapel of the Benedictine Abbey of St Adrian in Geraardsbergen, in East Flanders, south of Ghent and west of Brussels, where it first enters the historical record in 1600.

It was sold after Charles' death in 1781 to Emmanuel-Marie de Cock, Pensionary of Brussels and Greffier-Pensionary of the States of Brabant.

Copies are held by the Museo Nacional de San Carlos in Mexico City, the Wittelsbacher Ausgleichfonds in Munich, the church of St John the Baptist in Nethen, the National Gallery in Prague, and the Tula Art Museum.