Since the 10th century, San Gimignano was governed by the bishops of Volterra (a city in the province of Pisa), although they never lived in the city itself.

In the Middle Ages and during the Renaissance, Catholic pilgrims heading to Rome and the Vatican stopped in San Gimignano. The city lay on the ancient Via Francigena road, which was a pilgrimage route that ran from the cathedral city of Canterbury in England, France, and Switzerland to Rome, and next to Apulia, from where the ships departed for the Holy Land.

The city developed not only thanks to pilgrims but also through trade in agricultural products grown on the fertile soils of the neighboring hills.