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This towering altarpiece has never left the church it was built for. Luca Signorelli fitted 29 painted panels into an elaborate carved Gothic frame here in the mountain town of Arcevia, and it still stands over the high altar where he set it. He signed and dated it 1507 on the step of the Virgin's throne. The lower tier gathers the Virgin and Child among saints, including Sebastian and the town's own patron, Medardo. Small scenes of the Nativity and the Flight into Egypt run along the base. A commission this large needed many hands, and Signorelli, then in his late fifties and famous for his fresco cycle at Orvieto, worked with assistants, probably including the young Girolamo Genga.