The bridge is 89 metres long has a single arch 12.5 metres high; it is constructed in reinforced concrete and faced with white Verona stone. Destroyed by Allied bombing during the last war, it was built in its present form, to a plan chosen by the townspeople in a referendum, by the Aussant, Bellucci, Salghetti-Drioli, Trinci, Morganti, Bertini group (1946-1950).

In Roman times, the banks of the river Arno were linked by a bridge near the church of S. Cristina, along the Aemila Scauri Consular way, now via S. Martino. The crossing over the Arno was probably moved to its present position in the 11th century. Until 1183 it was the only bridge, and was called ponte de Arno, but after floods in 1179 destroyed all the bridges, including the ponte pisano, it was decided to build another one at the end of Via S. Maria and to re-build the ponte de Arno, which then acquired the name of ponte Vecchio. The bridge was crowded with buildings, shops and stalls that made the most of its central position on the main thoroughfare that crossed Pisa from north to south.

The bridge was repaired in 1388 by will of Pietro Gambacorti and collapsed once more in 1637. The reconstruction of a three-arched bridge, completed in 1660 by Francesco Nave, caused the demolition of several buildings on the two banks, and created a new panorama in Pisa, with the Logge dei Banchi facing directly on to the river.

Since the second half of the 17thcentury, the "Gioco del Ponte" has taken place on the bridge. It involves a struggle between teams from the two parts of Pisa, north and south of the river (Mezzogiorno and Tramontana), to win the bridge by pushing a heavy float into the adversary’s side of the bridge.