This chapter examines the urban evolution of cities in the Eastern Mediterranean during Late Antiquity, focusing on their transformation from classical urban centres to more utilitarian and fortified settlements. It argues that rather than experiencing outright decline, cities in the East adapted to changing political, economic and religious realities. Archaeological evidence demonstrates a marked shift from monumental civic spaces to structures that emphasised military defence, religious identity and practical urban needs. The author discusses key aspects of urban change, including the gradual abandonment of traditional agoras, the decline of monumental temples and the repurposing of public buildings for Christian churches and administrative centres. The chapter also explores the impact of imperial policies on urban planning in reshaping cityscapes through large-scale church construction, fortification efforts and infrastructure projects. The increased militarisation of cities, with the establishment of fortified kastra and urban defences, is another major theme. Regional variations are examined, showing that while some cities, such as Constantinople and Thessaloniki, thrived under imperial patronage, others faced economic stagnation and contraction. The chapter concludes that while Late Antiquity brought profound transformations to urban life, cities in the East remained resilient, adapting to new social and political realities rather than simply collapsing.