In keeping with Roman tradition, the first Christians were buried outside the city, often in catacombs. In time, the well-to-do sought burial inside a church, usually under the floor, or in a crypt, preferably close to the altar. As interior space became scarce, churchyards were created. The vast majority of people were simply wrapped in a shroud before burial in a wood coffin, but some were interred with objects symbolic of their esteemed rank. A fifth-century chieftain might be buried with his weapons, a bishop with his miter, or a king with some of his regalia.

By the thirteenth century, tomb sculptures themselves became elaborate status symbols. Carved effigies showed knights in full armor, kings with crown and scepter, architects with measuring instruments. Later tombs might show an entire family, carved in wood and brightly painted, kneeling in prayer. Brass tomb slabs were incised with figures and installed on church floors. Tomb sculpture both commemorated the deceased and invited prayers for his or her future life. Churches were often remodeled to display tombs prominently, or entire churches—such as Westminster Abbey in London or Saint-Denis near Paris—came to serve as royal necropoli.

Upon death, the soul was thought to leave the body through the mouth, awaiting the final Day of Judgment. At the end of time, the dead would rise up from their graves and Christ would either welcome them to heaven or banish them to eternal hell. The final days, described in the Book of Revelation, inspired commentary and vivid imagery in books, while scenes of the Last Judgment appeared frequently over church doorways, on church walls, or on small devotional objects.

In Byzantium, death was long regarded as the necessary and intermediary step to attaining salvation. Koimamai ("to sleep") designated the rest in death, a time when the soul separated from the earthly body and awaited the Last Judgment. As in western Europe, the living could offer prayers on behalf of the deceased and, in turn, the dead could intercede on behalf of the living. The Virgin was the primary advocate for mankind during the Last Judgment.

Byzantine burial attests to a wide range of funerary forms: burial in the earth in open-air cemeteries (the most modest form); within a church beneath the floor in unmarked graves; and in elite tombs within the church, distinguished by sarcophagi and funerary portraits.

As in the medieval West, church architecture could be heavily influenced by the desire to build lavish burial monuments, as in the case of Constantine's imperial mausoleum, the fourth-century Holy Apostles Church; the twelfth-century Monastery of Christ Pantokrator; and the fourteenth-century Church of Christ in Chora, all in Constantinople.