The painting, dating to between 1437 and 1439, reveals its true character as a masterpiece in the painter's attention to sophisticated details that recall the international Gothic of Gentile da Fabriano, in the compositional rhythm of the scene set off by the succession of female figures who, in a theatrical representation, act out their roles with great skill. The perspective recreation of the environment shows spatial innovations and great care for detail - note the multi-coloured glass window behind Saint Anna's bed, the realistic domestic interior, and the small "hortus conclusus" - all of which join elements from a well-consolidated tradition, such as the profusion of gold and the gem-like colours. The oanel has often been attributed to the "Osservanza Master", which scholars now tend to identify with the young Sano di Pietro.
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