The child lies naked on the bare ground. Angels kneel in heavy robes, and from the right three shepherds push in, painted with rough hands and open mouths. Tommaso Portinari had the altarpiece made in Bruges and shipped to Florence.
The altarpiece arrived in Florence in 1483 and was set up in the church of the hospital of Santa Maria Nuova. Its size and its oil technique astonished the Florentine painters; Ghirlandaio borrowed the shepherds two years later. The figures differ in size according to their rank, as in older art.