"Once it became apparent the [first] mural had been removed due to complaints from the church, I knew I had to re-create somewhere," Marsh told SBS News.
"I thought what better location then Rome the home of Vatican City."
The Vatican City, located within Italy's capital city, is the global headquarters of the Roman Catholic Church and where Pell spent the final years of his career as a member of the Council of Cardinal Advisers.
Despite complaints towards his earlier work leading to it being removed, Marsh said the reactions to the mural in Italy had so far been positive.
"A number of passers-by were all in support for the mural," he said.
"The Italian people I spoke to share the same disgust with the church abuses as many Australians."
The street artist said he thought it was important that Australians do "not let this issue disappear", explaining that he chose the location, in view of St Peter's Basilica, to amplify his message.
He added that the intention of the mural is to "highlight the hypocrisy of the church and combat its attempts to sweep under the rug its past abuses".
Source: Scott Marsh/Facebook
Pell has been a favourite subject of Marsh, whose distinctive brand of political art can be spotted all over Sydney.
In March this year, Pell was sentenced to six years in jail for sexually abusing two choirboys while he was the Catholic archbishop of Melbourne in the 1990s.
He has repeatedly denied the allegations and is in the process of appealing his conviction.
During the same-sex marriage debate, the street artist created a mural featuring Pell and former Australian Prime Minister Tony Abbott in an intimate position with the caption "the happy ending" behind the Botany View Hotel in Sydney's inner west. It was later removed.
More recently, a work that features Pell recreating the infamous Cricket ball-tampering incident of 2018 popped up in Redfern and is still visible.