This large picture was probably painted as the altarpiece of the Lady Chapel at St Adrian's Grammont, near Brussels. The kneeling King, Caspar, is probably a portrait of Johannes de Broeder, who became abbot there in 1506 and may have commissioned the picture. Behind him stands Melchior with a retinue of attendants. Balthazar is on the left. Further back an onlooker, seen through a doorway, may be a self portrait of the artist. The dove, symbol of the Holy Spirit, descends to the infant Christ from the brilliant star in the sky, and angels approach from a great distance through a series of arches, giving the scene a spectacular sense of space and depth.

Gossaert used the bright colour and highly detailed oil-painting technique of his 15th-century Netherlandish predecessors to sophisticated effect. The figures wear sumptuous costumes made of rich fabrics. The metalwork gifts presented by the Kings are elaborate and reflect current designs.