Painted during the 12th century by an unknown artist in the Umbria district of Italy, the cross hung for many years in a rundown church in San Damiano. As St. Francis was passing by the church, he heard a voice, went inside and knelt to pray before the cross. He then heard the words, "Francis, repair My house." St. Francis' first effort was to repair the church buildings, but eventually he came to realize that God wanted him to build up the lives of His people.

The cross is an icon cross - one that contains images of people who played a part in an event.. Therefore, it tells a story. The artist has represented Jesus as both wounded and strong - the crucified and the Risen Christ. There are five major witnesses. On the left are the Blessed Virgin Mary and St. John, to whom Jesus gave his mother at the time of His death. Mary Magdalene, Mary, mother of James, and the centurion are on the right.

Minor witnesses on the cross include soldiers and onlookers. The rooster represents the betrayal of Christ, and it is believed that the six figures at the bottom are the patron saints of Umbria.

Six angels, three near each hand of Christ, wonder at the event of the crucifixion. At the top of the cross ten more angels are crowded around Christ, welcoming Him as He climbs from the tomb and enters into heaven. Christ is shown fully clothed and carries a cross as a scepter. At the top of the cross, we see the right hand of the Father raising Jesus from the dead and giving Him a blessing for all that He has done. The Latin inscription reads "Jesus of Nazareth, King of the Jews".

The original San Damiano Cross was restored in 1938 and was placed for public viewing during Holy Week of 1957.