Because of the similarity of her name to the Latin for "lamb" (agnus), the lamb has been St. Agnes' symbol since the 6th century. On the feast day, 21 January, the Trappist fathers of the Monastery of Tre Fontane (near Saint Paul's Basilica) provide two lambs from their sheepfold to the Benedictine nuns of Saint Cecilia. They arrive at Saint Agnes' Basilica wearing crowns, lying in "baskets decorated with red and white flowers and red and white ribbons, red for martyrdom, white for purity."

For the festal Mass, the church, titular cardinal, and concelebrants are decorated with red, white and gold. During the Mass, there is a procession of little girls veiled and dressed in white lace with pale blue ribbons, followed by four resplendent carabinieri carrying the baby lambs. The lambs are blessed and incensed before being taken to the Vatican for the Pope's blessing. Then they are delivered to the Convent of Saint Cecilia to become the pets of the sisters until Holy Thursday (when they are shorn) before being sacrificed on Good Friday.

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