Founded some years ago as a noble brotherhood under the patronage of the Holy Orthodox Church, the Confraternity of the Knights of the Most Holy Trinity exists to promote and sustain the life of the Orthodox Church and its charitable works, particularly in southern Italy.

Italy's Orthodox heritage is reflected in the splendid Byzantine cathedrals of Venice and Ravenna in the north, and Monreale and Cefalù in Sicily. Until the twelfth century, when the Norman kings of Sicily gradually placed the region under the primacy of the Bishop of Rome (the Pope), this part of Italy was predominantly Orthodox in faith.

Italy has no national Orthodox jurisdiction. The Archdiocese of Palermo and All Italy is a diocese of the Ukrainian Autocephalous Church. There are also clergy and parishes dependent on various other jurisdictions. The Orthodox community of Italy comprises Italians, as well as immigrants from the predominantly Orthodox countries of Eastern Europe and elsewhere. The primary scope of the Confraternity, therefore, is its charitable work as a lay order within the world's oldest Christian church. Knights and dames of the Confraternity need not be Orthodox, but they must be practicing Christians of exemplary moral character. Members are invested into the Confraternity during a religious service. More than an honour, a gentleman's (or lady's) association with the Confraternity is a serious social responsibility undertaken not for prestige or recognition but to help his fellow man. The Confraternity is represented in Italy and several other countries of Western Europe, including the United Kingdom, Ireland, Germany and the Netherlands, as well as Canada and the United States.

There exist various charitable fraternities and orders of chivalry associated with particular churches or royal dynasties. In the Orthodox Church knighthood, as an institution, dates from medieval Constantinople, and confraternities are a far older tradition, originating with the oldest Christian communities. Indeed, the earliest military-religious knightly orders founded in the Holy Land were similar to medieval lay confraternities. Knights and dames of the Confraternity are dedicated to Christian service. The brothers and sisters of the Confraternity are referred to as knights and dames because most are associated with orders of chivalry or hold a rank or distinction regarded as being equal to that of knight.

While the Orthodox Church has numerous patriarchates and jurisdictions (there being no central ecclesiastical authority as in the Roman Catholic Church), the purpose of the Confraternity is the direct, ongoing support of a single Church and its communities.

The decoration of the Confraternity is an enamelled cross suspended from a deep crimson ribbon bearing, near its edges, two narrow grey stripes.

As a philanthropic institution of the Orthodox Church, the Confraternity is part of an ancient Christian tradition with a very modern purpose.