The Santuario della Madonna della Costa crowns the top of La Pigna, the medieval quarter, and is the first thing you see when you look up from Sanremo's waterfront. The climb up through the old town to reach it is half the point: the narrow alleys of La Pigna give way at the top to a small esplanade in front of the church with a view across the rooftops to the sea below.
The interior of the 17th-century baroque church is richly decorated with votive offerings, ex-votos, and silver objects brought by sailors who attributed their survival to the Madonna's intercession. The church is still an active place of worship and a destination for local pilgrims. The terrace outside offers one of the best vantage points in town, particularly in the evening light.