She was granted a decree of canonical coronation by Pope Pius X on 18 January 1909 and was crowned via Archbishop Eulogio Gillow y Zavalza on 31 July 1909.

I will give you another water with which you will extinguish the contagion and cure not only your family but all who drink of it, for my heart is always inclined toward the lowly and will not suffer to see such things without remedying them."

She then told him that he would find an image of her in the pine grove where they were standing, a "true portrait of her perfections and clemencies, and that he should advise the Franciscan fathers to place it in the church of St. Lawrence" that stood on top of the hill.

The friars observed the expression on Juan Diego's face as he told the story and believed him, possibly also because he was a regular altar server there.

The earliest mention of the shrine is found in the writing of the Tlaxcalan historian Diego Muñoz Camargo, who makes reference to there being a Franciscan missionary centre in Tlaxcala in 1588 or 1589 called Santa María Ocotla.

In an earlier book he refers to a nacimiento desta agua ("source of this water") where there is a cross in a group of forest trees that evokes great devotion.

Juan de Palafox y Mendoza, then Archbishop of Puebla, made a visit to the shrine in 1644, although he does not mention a statue.

He wrote in his own account of the visit that he recited the rosary there and praised the religious devotion of the inhabitants of the town.

The first mention of the statue occurs in 1689, in the frontispiece of a history of the city of Tlaxcala, published by Don Juan Benaventura Zapata y Mendoza.

Juan de Escobar is responsible for constructing the shrine with its present floor plan, with the chancel, transept, and cupola.