It was erected in 1651 in front of the church of Sant'Agnese in Agone, and yards from the Pamphilj Palace belonging to this fountain's patron, Innocent X (1644-1655). Inaugurated in 1651 the Four Rivers Fountain commemorates the Pope's redirection of water from the Acqua Vergine, an ancient Roman aqueduct, responsible for supplying much of Rome's water to the square in front of his family palace, the Palazzo Pamphili.

Bernini's fountain ingeniously incorporates an ancient Egyptian obelisk recovered from the Circus Maxentius in Rome. It is set on the rocks are four large figures symbolizing the four great rivers of the four known continents of the world: The Danube in Europe, the Nile in Africa, the Ganges in Asia, and the Plata for the Americas. The sculpted rock of the fountain base is represented with wood, and the one surviving figure, representing the Plata River, is modeled in clay. The design of the finished fountain differs slightly from that of the model: the circular form of the basin became an oval, and the openings in the rock were made more irregular.

According to tradition Bernini carved the arm of the statue lifted up to protect itself from the imminent collapse of the church that had been enlarged and reconstructed by his great rival Borromini.

Also, according to a report from the time, an event was organized to draw people to the Piazza Navona. The making of the fountain was met by opposition by the people of Rome for several reasons. Innocent X had the fountain built at public expense during the intense famine of 1646-48. The street vendors of the market also opposed the construction of the fountain as Innocent X expelled them from the piazza. The vendors refused to move and the papal police had to chase them from the piazza.