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The building was built by Domenico Fontana in 1589 as the new patriarch of the bishop of Rome, for will of Pope Sisto V, and includes:
- The Scala Santa (Holy Stairs) itself, flanked by four other flights of stairs, two on its right and two on its left;
- The chapel of San Lorenzo in Palatio, known as Sancta Sanctorum, that is the pope's private chapel, bishop of Rome;
- The oratory of San Silvester in Palatio, the entrance of which is on the first flight of stairs to the right;
- The oratory of the Blessed Sacrament at the Lateran (closed to the public) and the Triclinium Leoninum (visible from the street), both situated outside, next to the sanctuary

The Scala Santa (Holy Stairs) was originally the staircase of honor of the Patriarchate and was later used to access the popes ‘private chapel, the Sancta Sanctorum, situated on the first floor of the Building. From the mid 15th century the staircase was thought to be the one that Jesus of Nazareth ascended in Pontius Pilate’s Praetorium during his trial.

The Scala Santa (Holy Stairs) consists of twenty-eight white marble steps, now encased by wooden steps and  is situated on the first floor of the building. The Scala Santa (holy Stairs) , which starts from a lobby decorated with marble groups, has frescoes on the walls and on the ceiling referred to stories of the Old and New Testament. According to the religious devotion, the 28 steps should be covered on one’s knees.

The chapel of San Lorenzo in Palatio, more commonly known as the Sancta Sanctorum, was originally the private chapel of the popes; it  is what remains of palazzo patriarcale in Lateran, the headquarter of the bishop of Rome. The name of the Sancta Sanctorum, which evokes the Temple of Jerusalem where the Arca dell’Alleanza was kept, comes from the fact that here were kept the most precious Christian relics.

The interior of the chapel of San Lorenzo in Palatio was decorated by the Cosmati;  the  sacred image on the altar, as an inscription indicates,  is an “acheropita” , which means that is not painted by human hand; according to tradition, was painted by Luca Evangelista,  helped by an angel . Above the altar the inscription reads: “non est in toto sanctior orbe locus” (there is not in the word a holiest site)

On the right top of the Holy Stairs, there is the oratory of St. Sylvester, built by Domenico Fontana, replacing the existing chapel built by Theodore I in the seventh century, which was within the Palazzo Episcopale in Lateran. It is located next to the chapel of the Sancta Sanctorum. On the ceiling there is the image of the Trinity with the Doctors of the Church, whereas on the left there is the image of St. Lawrence, painted by the Franchi in the late sixteenth century.