Gently, Christ places the ornate gold crown upon the Virgin Mary's slightly bowed head. Groups of musical angels watch from either side as she becomes the Queen of Heaven. Gentile da Fabriano used extensive tooling, decorative patterning, gold leaf, and rich pigments to create a sumptuous surface resembling tapestry. The complex patterning, elaborate materials, and long flowing lines of the robes of the Madonna and Christ characterize the International Gothic style.

Gentile was commissioned to paint this scene for his native town, Fabriano, when he was at the height of his fame. The gold-encrusted panel functioned as a processional standard held aloft in parades that honored the Virgin Mary. The panel originally depicted The Stigmatization of Saint Francis on the reverse. Sometime prior to 1827, the panel was sawed into two sections; the Saint Francis panel is now in a private collection in Italy.