The Department for the Byzantine-Medieval art is responsible for the care of the artistic heritage of the Museums and the Apostolic Palace from the end of the late Middle Ages (late eleventh century) to the early years of the fifteenth century with regard to the artists belonging to the International Gothic movement. The Department also includes the collection of icons. 

The Department’s task is the protection, enhancement and study of medieval paintings and icons and of what remains of the masonry and decorative works of the ancient Vatican Papal Palace, whose foundation and gradual expansion before the fifteenth century are due above all to the pontiffs Eugene III (1145- 1153), Innocent III (1198-1216) and Niccolò III (1277-80). 

Particular attention is paid to the scientific updating, to the didactics and to the exhibition of medieval paintings in the first two rooms of the Pinacoteca. Among these works on display are masterpieces of the great protagonists of the painting of the period: Margaritone, Simone Martini, Lippo Memmi, Ambrogio Lorenzetti, Giotto, Puccio Capanna, Vitale da Bologna, but also Gentile da Fabriano and Olivuccio di Ciccarello, lingering exponents of the International Gothic.

Since 1978, the collection of icons has been exhibited in Room XVIII of the Pinacoteca, a space that is dedicated entirely to Eastern sacred art. 

Almost all the paintings come from the Sacred Museum of the Vatican Library, where the collection began in 1820 with the intention of documenting the origins and events of Christianity thanks to the precious iconographic repertoire accompanying these works. The "Primitives collection" was later enlarged and in 1837 the paintings were placed in the wardrobes designed by Raffaele Stern for Cardinal Zelada of the current “Room of the Addresses.”

Saint Pius X (1903-1914) was the first to consider medieval paintings not only as testimonies of faith but also as works of art; it was thus that the so-called "Primitives" were passed to the Vatican Pinacoteca, which was reorganized in 1909.

The current site of medieval paintings is the building erected by Pius XI (1922-1939) in which all the paintings of the old Pinacoteca (1932) converged. The department is dedicated to the study of works and their restoration, to the curation of exhibitions and temporary displays. The Department dedicates in-depth studies to the works being restored, curates exhibitions and temporary installations, updates the didactic section of the works on display, and participates in conferences The results of its research find space in targeted publications.