The Virgin is shown at half-length, her head inclined to the left, holding Christ to her right. He also looks to the left, and holds a goldfinch in his left hand. They are flanked by a saint on either side; possibly Saint Jerome to the left and a Franciscan, perhaps Saint Bernardino of Siena, to the right. The heads of six angels fill the upper corners. The tooling of the work is particularly sophisticated, with a wide variety of punches applied.

Sano di Pietro is copiously documented as a panel-painter and miniaturist, and his prolific workshop produced works of distinct character and little variation in style. There is no question that this panel originated in the workshop of Sano, but it is not necessarily by his hand. It is iconographically identical with another version in the Kress Collection, National Gallery of Art, Washington, which has been associated with an altarpiece in the Accademia, Siena.

Inscribed in the Virgin's halo: 'AVE. GRATIA. PLENA. dOMINV....'