The presbytery is slightly raised, with an apse decorated on the sides by walnut wooden choir stalls for the canons, and in the center by the majestic altar made of polychrome marble inlay by Felice and Loreto Di Cicco from Pescocostanzo. The tabernacle altar, made of marble with pairs of Corinthian pilasters supporting an overhanging entablature on the two extreme sides, which are upheld by columns, from which two strong lateral volutes depart, and in the center a white marble medallion featuring a pair of cherubs, has in the center a full arch, which houses the niche with the 15th-century statue of the Madonna. Above it is the coat of arms of the Municipality of Lanciano, projecting outward. At the base of the balustrade by Crescenzo Trinchese, there are four Angels holding cornucopias, a work by Francesco Pagano (Naples, 1695–1764). The faux marble coverings were done by the Lombard Alessandro Terzani, while on the sides of the Madonna statue’s frame and above the choir stalls, there are two allegories and episodes depicting Solomon and the Queen of Sheba, and David and Abigail, created by Giuseppangelo Ronzi di Penne, a follower of Giacinto Diano, in 1805. The painting of David and Abigail currently in place is a 1934 replica by Francesco de Vincentiis, as the original by Ronzi was destroyed by a fire in 1933.

The frame is the work of the marble worker Crescenzo Trinchese (documented 1743–1784), who, on November 8, 1758, had committed to completing it for 7,000 ducats, along with the altar, which was an integral part, and the presbytery balustrade, to be finished by 1762, under the direction of the architect Gennaro Campanile. With its move in 1786–1787 from the original chapel to the presbytery, it was stripped of the altar, which was later reassembled, with scagliola additions, in the Chapel of the Sacrament, and underwent modifications and additions to the base.