Rubens painted this work in 1626 on commission for the Aalst guild of hop and grain merchants as he was at the pinnacle of his career. Their patron saint was Saint Roch, the figure whom the dramatic scene shows being appointed by Christ as the patron saint of the plague sufferers depicted at the bottom. Saint Roch, it is worth noting, caught the plague himself and withdrew to the forest, where a dog brought him his daily bread. In the end, legend tell us, he died in prison in his hometown of Montpellier.
Work on this gothic church began with the construction of the choir at the end of the 15th century and would last until 1660. During the 1800s, the building, until then Aalst’s only parish church, was restored in neo-gothic style. Medieval murals were rediscovered later. And a thorough refurbishment took place after a fire in 1947. At the moment, the church is in the process of being restored yet again.