The first cathedral of the city was built in the 11th century by King Géza I who was later buried there. This church stood on the area of the present day Géza király Square but it was burned down during the Mongolian invasion. Later a Renaissance basilica was built here which was later destroyed by the Ottoman armies.

After the expulsion of the Ottomans, the Saint Michael Church was used temporarily as a cathedral. Finally Bishop Károly Esterházy decided that instead of using the church that was in gradually worsening condition, a new cathedral should be constructed. He commissioned the Austrian architect Franz Anton Pilgram to design a new building. Pilgram planned a richly decorated church that would have been a smaller version of the St. Peter's Basilica in Rome. The church would have been connected to the Bishop's Palace with a colonnade. However Bishop Esterházy was relocated to the Archdiocese in Eger and Prince Archbishop Christoph Anton Migazzi was made an administrator of the Bishopric of Vác. The new bishop found the plans too expensive so he asked another architect, the French Isidor Canavele, who was living in Vienna at the time, to design a new cathedral which became the present day late Baroque building.

The construction began in 1761 and the dedication took place in 1772 though the interior was only finished in 1777. The cathedral is monumental in its dimensions: its exterior length is 72 meters, interior length is 60 meters and height is 55 meters. It is the third largest cathedral in Hungary open to the public after the Esztergom and the Eger Cathedrals. The cathedral has been dedicated to the Assumption of the Blessed Virgin and St. Michael the Archangel. Between the two towers of the facade, there is a portico with Corinthian columns. Above the entablature, there are statues carved by a local sculptor, József Bechert: Peter, Paul, Virgin Mary, Joseph, John and Jacob. On the walls of the hall, there are stucco reliefs depicting biblical scenes and the coat of arms of Migazzi. The interior of the single nave church is in late Baroque style. The frescoes of the main altar and the dome were painted by one of the most significant Austrian painters of the 18th century, Franz Anton Maulbertsch. The main altarpiece depicts the visit of Virgin Mary at Saint Elisabeth, and the fresco of the dome depicts the residents of heaven, among them Hungarian saints. Two years after it has been finished, Migazzi ordered the panel of the main altar to be covered with a canvas painting depicting the crucifixion by Johann Martin Schmidt. The fresco was only freed and restored 170 years later in 1944. The main altar is separated from the nave by a Renaissance which remained from the earlier basilica. The pillars holding the dome are carved with portraits of bishops Pál Forgách, Károly Althan, Frigyes Althan and Christoph Anton Migazzi. The altarpieces in the transept are copies of painting in Italian churches, the altarpieces of the two side altars were painted by Johann Martin Schmidt.

Up until the 1940's, besides the two Maulbertsch frescoes, there were no other paintings on the walls of the church. However, in this decade the frescoes of István Takács were painted on the four gigantic walls of the transept and the semi dome was decorated with a wall painting of Béla Kontuly. There are regular services held in the Cathedral and it is a popular site for weddings and baptisms. During celebrations, it is the home of concerts which make good use of its fine acoustics.