Three young cousins of the infants, the later disciples Simon, Jacob and John, pour wine into a chalice in the centre of the painting which is a reference to the Eucharist, and beyond them a sculpture of Abraham's sacrifice of Isaac on the altar represents God's sacrifice of Jesus.

In the doorways of the choir gate stand the other two former husbands of Saint Anne, the fathers of the other two Marias who are positioned behind St. Elisabeth.

This painting is a former altarpiece of an unspecified church, though it is tempting to imagine similarities to the Commanderie van Sint-Jan where Geertgen is known to have lived and worked: Janskerk, Haarlem.

In his translated Schilder-boeck, Hessel Miedema reported that Geertgen died somewhere between 1486 and 1492, while recent dendrochronology, on the other hand, places the painting around 1496 at the earliest.

It was the subject of a mini-exhibition after 17 years were spent 1983-2000 restoring 12 centimeters of water damage at the bottom of the painting.