The ex-voto is an offering to a deity in fulfillment of a vow, a promise made in a moment of despair. Delivered from illness or imprisonment, the votary visits a shrine and publishes her commitment with a gift. Ex-votos—sometimes valuable gifts, sometimes mere evidence—are often misrecognized by scholarship, which confuses them with cult images, miracle-working images, and image-borne pleas for spiritual salvation. In fifteenth-century Italy, votaries began to offer painted panels narrating their own stories. This new class of ex-voto, resembling works of sacred art, only invites more confusion. The talk attempts to distinguish the ex-voto from other devotional images, including artworks, on the basis of the concepts of reference and authorship.