The Church of San Giuseppe dei Vecchi is a monumental church founded by the Order of Clerical Regular Minor, belonging to the Caracciolo family, who bought, at the beginning of the 1600s, from the Carafa nobles a building to increase their presence in that part of the city, that from original village was transformed into a neighborhood. In 1616 the original Carafa palace was transformed into a monastery and a small church dedicated to St. Joseph was founded. In 1634 Andrea Cavallo, father caracciolino, entrusted Cosimo Fanzago with the design of a larger and majestic church. The Fanzaghian project went slowly and suffered prolonged interruptions, including the plague epidemic of 1656. The Church was consecrated still incomplete in 1665, in fact, lacking the dome and the vaults, the factory was covered by a temporary roof. Later the chapel of St. Anthony, the high altar and the altars of the chapels were completed. From 1706 to 1712 the architect Onofrio Parascandalo first completed the work, then Giovan Battista Manni. After the earthquake of 1732 which had caused serious damage to the supporting structures and the dome, the Order commissioned Nicola Tagliacozzi Canale for the restoration and consolidation of the structure, which created the stuccos of the dome and chapels, as well as the construction of the choir above the entrance, now lost.
On the facade, the piperno portal dates back to 1727 and is the work of Francesco Solimena. The church plan is a Greek cross with the longitudinal axis longer than the other axis, and thanks to the significant height of the vertical structures and the dome, there is a scenographic effect of great amplitude in a small space. The domed vault, which is composed of a vaulted ceiling and a pavilion, rests centrally on four large pillars surmounted by a rich composite style trabeation with large stucco moldings in the pendentives and is supported laterally by four large barrel vaults placed at the base of its four sides of the dome. Natural lighting is ensured by large windows placed on the main façade and on the apse, also by large windows placed on the barrel vaulted ceiling that support the dome. The church has four corner chapels and the apse, the choir behind the apse is divided by the main altar. The apse area has a seventeenth century canvas, by an unknown artist, depicting the Holy Family. Behind the choir, in correspondence of the left aisle, is the Sacristy which originally communicated with the adjacent Cloister. The internal perimeter walls and the intrados surfaces of the barrel vaults are embellished with eighteenth-century stuccoes and wall tempera depicting scenes from the Old and New Testaments, the life of Saint Joseph, figures of Prophets and Saints. In the side aisles, the altars in the transept are embellished with stuccos by Manni, in the left chapel by an oil painting depicting St. Michael the Archangel by Nicola Maria Rossi and in the right chapel by a painting of San Francesco Caracciolo by Antonio Sarnelli. In addition there are wooden sculptures representing St. Anne, St. Anthony of Padua, the Ecce Homo, the Crucifix and a sculpture made of papier-mache representing St. Anne of particular interest for invoice and finishing. On the high altar we see two eighteenth-century wooden angels. In 1926 the Church of San Giuseppe dei Vecchi was elected Parish. In recent times, at the behest of the Ruotolo brothers, a reproduction of the Grotto of Our Lady of Lourdes was made on the bottom of the right aisle and the Parish was later named "Saint Joseph of the Old and Immaculate of Lourdes". Starting from the 30s of the twentieth century, a testimony of the graces received, most of the walls were covered with small gravestones ex voto. Today the complex must be seen taking into account the overlapping of many architectural solutions and choices, sometimes even contradictory and in conflict with each other, due to the alternation of famous architects of the time and the incomplete seventeenth century. In the Church the bodies of the Elio and Dolindo Ruotolo brothers are buried.