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The church of Santa Maria in Cosmedin, oriented southeast, is a three-aisled basilica with three apses, a crypt, an external narthex, a porch (prothyron), and a bell tower. The church was established within the pre-existing structures of a late antique colonnaded hall in the 6th century. Its identification as a diaconal church has been documented since the mid-8th century. The structure underwent significant expansion during the pontificate of Pope Hadrian I (772–795), who added a crypt and transformed the original building into a three-aisled church. Subsequently, under Pope Nicholas I (858–867), the church was restored and enriched with the addition of an oratory, a triclinium, and a sacristy. Traces of murals from both Carolingian interventions are still preserved today. The consecration of the altar by Callixtus II (1110–1124) in 1123 marked the completion of significant building activity, including the construction of the bell tower and the modernization of the portico and the porch. The façade was renewed with the addition of a “cavetto” around 1300 under Cardinal Francesco Caetani. Later post-medieval interventions, including the construction of the façade by Giuseppe Sardi in 1718, significantly altered the original appearance. Between 1896 and 1899, restorations directed by Giovanni Battista Giovenale restored the medieval appearance, removing Baroque modifications and integrating missing columns with spolia materials. The building preserves early medieval decorative elements, including Byzantine and Carolingian marble fragments, inscriptions, and Cosmatesque liturgical furnishings from the first quarter of the 12th century, attributed to the workshop of Paulus. Noteworthy features include the opus sectile pavement, the Gospel ambo, the Epistle pulpit, the papal throne, the Paschal candlestick signed by Paschalis (dated to the mid-13th century), and the Gothic ciborium signed by Deodatus (c. 1300). The wall paintings in the central nave and those in the tomb of Alfanus, dating to the 12th century, bear stylistic analogies with those in Castel Sant’Elia. In the upper register of the frescoes decorating the high clerestory walls, dating around 1120–1123, bearded masks with horns appear, believed to be copies of the “Bocca della Verità” (Mouth of Truth). This suggests that the renowned artifact was already located at the church by the 12th century, though it likely had been there for a much longer time.