In this representation of the Virgin's sorrow for her dead son, she embraces the dead body of Christ, who is barely covered by a loincloth. The Cross that symbolizes his martyrdom stands behind them. On the left are smaller images of the anonymous donors, who sing the Miserere mei, Domine (“Lord, have mercy on me”), which is the beginning of Psalm number 50, that asks Christ for forgiveness in order to merit the fruits of Redemption. A walled city, possibly Jerusalem portrayed as a Medieval city, appears in the rocky landscape of the background.

Fernando Gallego eliminates the wounds and blood of Christ that usually appear in representations of the Pietà. Instead, he focuses the scene's dramatic weight on the intensity with which the Virgin embraces her Son, and on her expression, emphasizing Mary's solitude. In this pyramidal composition, the Virgin wears a red tunic that alludes to the pain of Christ's Passion, and blue robes.