Created by King John VI of Portugal on 4 November 1801, in recognition for the devotion of Elizabeth of Aragon, the Queen Saint consort of Portuguese King Denis I. John VI invested Carlota Joaquina, his wife, as Grand Mistress of the Order. The Order is exclusively for Ladies and it distinguished Catholic noble women. The total of members that this order could have was twenty-six.
In 5 October 1910, the Monarchy was replaced by a Republic and the Order which was considered Dynastic, was still bestowed by King's Manuel II of Portugal who also awarded it to his wife in exile. After his death the Queen and Queen Mother both continued to use the order's insignia of Grand Mistress. In 1986 Duarte Pio, Duke of Braganza re-established the Order of Saint Isabel, as an honorific dynastic order of the Portuguese Royal Family, and claimed the Sovereign Grand Mastership of this Dynastic Order. The Duchess of Braganza is the current Grand Mistress and besides distinguishing Portuguese Noblewomen on the Saints Feast Day celebrated at the Monastery of Santa Clara-a-Nova in Coimbra each year on July 4, the Royal House has also distinguished, since the year 2000, various Queens, Princesses and women dedicated to the support of Portuguese Charities.
The order's sash is pale pink and has a white stripe in the middle. On the accompanying crowned medallion is a picture of the Queen Saint giving money to a poor man. This picture is surrounded by a frame with roses (an allusion to the Queen's miracle). The insignia's motto is Pauperum Solatio.