The Church of the Mother of God of "the Three Hands", which is mentioned several times in the charter of the Serbian king Stefan Uroš II Milutin for the Monastery of St. George-Gorg in the year 1300, played an important role in the history of medieval Skopje. Probably the church had already existed in Byzantine times. It could well be that she is identical with a church, which is mentioned in 1204 (et episcopus licet indignus sanctissime ecclesie dei genetricis de Scopia Marinus). The Church of the Mother of God of "the Three Hands" was initially the see of the local bishop and then (after 1346) of the Metropolitan of Skopje, which is, amongst others, attested in a Serbian charter of the emperor Stefan Uroš IV. Dušan from 1347 (… такожде и подвигосмо всечьстноую Скопию, чьстнаго и славнаго града Скопиꙗ Троѥроучицоу, на прьвопрѣстолноую митрополию, поискасмо пискоупиѥ подложити вь область митрополиѥ светые Троѥроучице Скопьскыѥ, …). The Metropolis of Skopje is hereby indicated as "prvoprestolna" (πρωτόθρονος). The beauty of the church is described by the Byzantine diplomat Theodōros Metochitēs in his account of the embassy (Πρεσβευτικός) to the Serbian royal court in 1299 (ἐν δή τινι λοιπὸν τῶν κατὰ χώραν ἱερῷ καλλίστῳ τῆς Θεοτόκου γιγνόμεθα). She was refurbished by king Milutin (и сьзда [...] црьковь глаголѥмоу Троѥроучица вь славьнѣмь градѣ Скопии). Her name derives from the miracle-working icon of the Mother of God of "the Three Hands", which was donated to this church by the Serbian Saint Sava around 1230 and which is today kept in the Serbian monastery of Chilandar on the Holy Mount Athos. Stefan Uroš IV Dušan was crowned emperor in the Church of the Mother of God of "the Three Hands", while his son Stefan Uroš V ordered the church to be
enlarged and decorated. It fell into disrepair and vanished most probably after the Ottoman conquest of Skopje at the end of the 14th century, but at the latest in the 17th century. Radoslav Grujić localised the Church of the Mother of God of "the Three Hands" approximately between the lower course of the river Serava and the Upper Town of Skopje, which is confirmed by the context of king Milutin's charter for the Monastery of St. George-Gorg from the year 1300.