The origin of the icon that is at the center of devotion to Our Lady of Perpetual Help is unknown.
Many have thought that St. Luke painted it, but its existence prior to the late Middle Ages cannot be confirmed.
Likely it is Eastern in origin due to the Byzantine style and Greek lettering.
The icon features the child Jesus fleeing into his Mother's protective arms as the Archangels Michael and Gabriel show Him the instruments of crucifixion. The Greek letters spell out the first letters of Mary and Jesus' names.
The icon arrived in Rome in the 15th century after a merchant who had heard about a miraculous image on the island of Crete went to the island and stole it. When he arrived in Rome with the icon among his wares, he fell very ill. As he lay dying, he ordered that a friend place the icon in a church, perhaps hoping that it would alleviate his suffering. The friend took the icon to his own home, where his wife hung it in their bedroom.
The Virgin evidently was not pleased with this arrangement, and several times appeared to the man and told him that she wished for her image to be placed in a church. The man, despite the miraculous visitation, was not moved to relinquish control of the image. The Blessed Virgin next appeared to the man's daughter and asked that the icon be enshrined in a church between the two very large churches of St. Mary Major and St. John Lateran. The daughter communicated this to her father and he relented, and so the icon was enshrined in 1499 in St. Matthew's, the church that lies between the two larger edifices.
Pilgrims flocked to the small church for 300 years to pray before the miraculous image, until Napoleon's invading army destroyed the church in 1798. Once the soldiers had left the area, people searched the ruins looking for the image but could not locate it anywhere. It seemed that the image had been lost, and for the next 60 years there was no mention of it.
In 1855, the Order of Redemptorists came to Rome and were granted possession of the location where St. Matthew's had once stood to build a church in honor of their founder, St. Alphonsus Liguori. It happened that a young Redemptorist priest remembered that as a young boy he had been told of a miraculous image that had once been enshrined in the previous church. The image had been safely transferred to an Augustinian monastery near Rome.
When the Redemptorists heard of this, they petitioned the pope to allow the image to be returned to the spot that the Blessed Virgin had requested. The pope granted their request and further commissioned the Redemptorist order to spread devotion to Our Lady of Perpetual Help throughout the world. The image was transferred in a solemn procession on April 26, 1866, to the Church of St. Alphonsus.
Today, replicas of the image of Our Lady of Perpetual Help grace the altars of countless churches throughout the world.