The adoration of the shepherds was never treated as a separate theme in the East, and in the West not until the 15th century. At first, in Early Christian art in the 4th century, one or more shepherds were included in scenes of the adoration of the Magi, the Wise Men who came from the East to worship the Child. They were depicted in such scenes because, as the first local people to worship Christ, they symbolize the spreading of Christianity among the Jews, just as the Magi, the first of the Gentiles to see and worship the Child, symbolize the spread of Christianity throughout the pagan world.

Because of the simple piety illustrated by the event, the adoration of the shepherds was a popular subject for altarpieces and other devotional paintings in both the Northern and the Italian schools in the Renaissance and Baroque periods. In many of these paintings the shepherds bring humble gifts, symbolic counterparts of the magnificent ones brought by the Magi; the most frequent gift is a lamb with tied feet, perhaps also symbolizing Christ's sacrifice. At the end of the 16th century the theme of the adoration of the shepherds provided inspiration for genre painting, and the taste for pastoral subjects contributed to its popularity throughout the 16th and 17th centuries.