The Spedale became important a short time and a new religious order was founded to fulfil the hospitality needed. It was called Knights of the Tau (Cavalieri del Tau) and from Altopascio they spread throughout all Europe. They were also called "Order of Saint James of Altopascio" (in Italian: Ordine di San Giacomo d'Altopascio or Ordine dei Frati Ospitalieri di San Jacopo), a military order, perhaps the earliest Christian institution that combined protection and assistance to pilgrims, managing the hospitals while serving a military wing.
The historic centre of Altopascio still has architecture and artworks of inestimable value, like the church of San Jacopo, built in 1100 AD during the period of the ‘Ordine degli Ospitalieri’. This church has a beautiful façade made of smooth stone on the bottom and white and green marble on the top, enriched by a lunette and two lions at the entrance. The imposing bell tower next to the church was built around 1280 and still maintains a medieval-fortress style. The most splendid part of the historic centre is the Piazza degli Ospitalieri, which features an interesting octagonal-shaped water well. Today the square overlooks the Library and some buildings belonging to the municipality.
Between Altopascio and Chiesina Uzzanese there is the Lake Sibolla, a small basin of water that, despite its small size, is undoubtedly one of the most precious natural environments in Italy.