As early as the 17th century, the first foundations for a 60-meter-high dome building were begun in the pilgrimage site according to plans by Enrico Zuccalli, the foundation stone of which had been laid by Elector Maximilian. The foundations were discovered in the 1980s while building an underground car park. A model of this construction is in the Altöttinger Heimatmuseum.
When Altötting was connected to the railway network at the end of the 19th century, the number of pilgrims rose sharply and the existing churches could no longer cope with the streams of pilgrims. So it was first thought about an expansion of the existing churches, before under the patronage of the Prince Regent (1886–1912) and later of King Ludwig III. (1912–1918) a new building was driven by the Capuchin Order.
Today's basilica was designed in the neo-baroque style by the architect Johann Baptist Schott based on the towerless facade of the monastery church of Fürstenfeld. According to the original plan, the Altötting basilica was to have two flanking towers. The general contractor was the local construction company Lehner, the construction foreman Josef Leberer was responsible for the vault construction. The church was financed by a large number of donations from all over Bavaria. After a construction period of 2½ years, the church was inaugurated on October 13, 1912 by the Bishop of Passau Sigismund Felix von Ow-Felldorf.