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In 313 AD, Christianity was recognised by the Roman Empire and this also spread to the Dodecanesse. The empire of the Byzantium exercised control of Patmos and the other islands and by the 4th century the temple to Diana had been removed. Directly over this temple a church dedicated to St. John the Theologian was built but this was destroyed later between the 6th and 9th centuries during a series of raids by various Arab groups.
The island remained deserted until 1088, when the Emperor granted Patmos to the monk Christodoulos. His intention was to establish a monastery and built build this monastery over the remains of the little church built over the remains of the a temple dedicated to Diana. The monastery, has since been in continuous operation for over 900 years.
During the 11th and 12th centuries, the island of Patmos was also subject to raids by the Saracen and Norman pirates, which were the catalyst for the fortified walls surrounding the monastery giving it the modern day castle-like appearance. The small town (Chora) within the "castle" was probably established during the middle of the 17th century and has a labyrinth style street arrangement. <ref> Labyrinth style street designs are common on the islands purposely arranged to create a sence of confusion to pirates or threats intent on raiding the towns. </ref>
During the Turco-Italian War of 1912, Patmos was captured and controlled by the Italians. The island remained under their control until the end of World War II, when it was returned to Greece.
The whole island is dominated by the two monasteries, built in his honour and memory, and Chora, the island’s historic center, are all declared World Heritage sites by UNESCO in 2006.
