Probably built by Marcus Aurelius in 211 A.D., it was originally called "Pons Aurelius" and successively "Pons Janicularis" due to the nearby Janiculus Hill. Destroyed by a flood of the Tiber river in 792 it was called "Rotto" (Broken) until it was restored by appointment of Pope Sixtus the Fourth (hence its current name) in the years from 1473 and 1479 on the occasion of the Jubilee. 

Celebrated by Vasari and by the humanists it was compared for its proportions and the materials used with the ancient solid Roman bridges. It has four stone arches and it is 108 m (120 yd) long and 11 m (12 yd) wide. The bridge has the characteristic humpbacked shape and presents a large round whole framed in travertine at its center. 

The hole is an outlet for the waters on the occasion of floods and has always been used by the Romans as an accurate indicator of the dangerousness of the waters. Unless it is flooded by the surges, the Trastevere Quarter has nothing to fear.