In the west centuries ago manuscripts were replaced by printed books, and relegated to mostly secular libraries as a result of religious and political upheavals. In the Christian Orient such changes were slower and remain less advanced. Manuscripts have not entirely vanished from regular use, and Christian communities retain ownership of significant collections of their historic manuscripts. The vital connection between manuscripts and religious culture endures, even if attenuated by persecution, diaspora, technology, and other aspects of modernity. This essay provides an historical survey of these issues in both Europe and the Christian Orient (limited here to the Middle East, the Caucasus, and Ethiopia/Eritrea).