It is estimated that the largest cities in Western Europe in 1330 were Paris and Granada. At this time, Paris was the seat of power in northern France, while Granada had become the largest multicultural city in southern Spain, controlled by the Muslim, Nasrid Kingdom during Spain's Reconquista period. The next three largest cities were Venice, Genoa and Milan, all in northern Italy, renowned as important trading cities during the middle ages. In October 1347, the first wave of the Black Death had arrived in Sicily and then began spreading throughout Europe, decimating the population.

In the year 1500, the share of Western Europe's population living in urban areas was just six percent, but this rose to 31 percent by the end of the 19th century. Despite this drastic change, development was quite slow between 1500 and 1800, and it was not until the industrial revolution when there was a spike in urbanization. As Britain was the first region to undergo the industrial revolution, from around the 1760s until the 1840s, these areas were the most urbanized in Europe by 1890. The Low Countries Prior to the 19th century, Belgium and the Netherlands had been the most urbanized regions due to the legacy of their proto-industrial areas in the medieval period, and then the growth of their port cities during the Netherlands' empirical expansion (Belgium was a part of the Netherlands until the 1830s). Belgium was also quick to industrialize in the 1800s, and saw faster development than its larger, more economically powerful neighbors, France and Germany. Least-urban areas Ireland was the only Western European region with virtually no urbanization in the 16th and 17th century, but the industrial growth of Belfast and Dublin (then major port cities of the British Empire) saw this change by the late-1800s. The region of Scandinavia was the least-urbanized area in Western Europe by 1890, but it saw rapid economic growth in Europe during the first half of the following century.

After the fall of the Western Roman Empire in the 5th century, the Catholic Church, centered in Rome, became the largest unifying authority in Southern and Western Europe. However, it was not the Italian peninsula that has the highest number of churches, monasteries, and abbeys during the Middle Ages, but France.

The monastic movement of St. Benedict, formed in the 6th century, eventually consolidated its power in France and gained widespread influence over the region. By the 12th century, the Benedictine monastery in Cluny, Burgundy, controlled over 1,000 other abbeys (even as far as Scotland), and was considered the leading center of Christian monasticism. In many ways, the Church was considered a more powerful authority than monarchies in the Middle Ages, and the hierarchical nature of the Church saw cardinals and bishops elevated to positions of significant power. In addition to being places of worship, abbeys and monasteries also became trading and communal centers for local populations before the era of urbanization.

As early as 1319, allegations of well-poisoning had been levelled at leper communities in Europe, in an attempt to demonize and ostracize this group in society. In France and Spain in 1321, the "leper's plot" developed into a widespread conspiracy, claiming that leper communities were acting on the orders of the Jews or Spanish Moors, poisoning water supplies in an attempt to spread disease among Christians. Under royal decrees, many lepers were then tortured into confessing to these acts, and were subsequently burnt at the stake (although this was often carried out by vigilante mobs before it could be done by the courts). After the initial hysteria in 1321, the involvement of lepers was quickly dismissed, and a papal bull was introduced to grant protection to leper communities in France; this however did not dispel the myths surrounding the Jews' involvement in the conspiracy, and the issue emerged again a few decades later. Why the Jews were blamed When the bubonic plague made its way to Europe, many were eager to find a scapegoat on whom they could blame their misfortune. The "well-poisoning" accusations were quickly raised again against Jewish communities in France and Spain, and also across the German states. Historians point to several reasons why Jews were blamed for the Black Death; many Jews lived in separate communities and did not use the same common wells, and Jewish religious practices promote bathing and hand-washing; both of these factors meant that the plague spread differently and at a different rate among Jews than it did among the general population. Modern historians also point to the fact that Jews were often moneylenders, and their debtors often used the plague as an opportunity to expunge their debts; Holy Roman Emperor Charles IV also forfeited the property of Jews who were killed in the pogroms, giving further impetus to these mobs. Anti-Jewish pogroms The first reported pogroms took place in Toulon in 1348, before the violence then spread across the rest of Western Europe. Over the next three years, hundreds of Jewish communities were attacked and exterminated, with the majority taking place in the German states. A number of larger communities, such as those in Cologne and Mainz, were destroyed completely, resulting in the deaths and forced conversions of thousands of Jews. Pope Clement VI introduced two papal bulls in 1348, which granted the church's protection to Europe's Jews. He also urged the clergy and nobility to take measures that protected Jews in their local areas, although most sources show that authorities were apathetic or complicit in the actions of the mobs. There is even evidence that authorities orchestrated several of the pogroms, such as in Strasbourg, where authorities led the city's Jewish community to a newly-built house outside the city, but when they arrived, any Jews who refused to convert to Christianity were then burned alive inside the house. Legacy Many of the sources present different versions of events, with death tolls ranging from one hundred to several thousand in some cases, while some sources also claim that Jews set fire to their own homes rather than convert. It is now impossible to confirm the exact sequence of events, or the actual number of deaths resulting from these pogroms, however, the limited sources available do provide a brief foundation for the modern understanding of medieval anti-Semitism and the destruction inflicted upon the Jews during the plague. It is also important to note that these pogroms were not unique to the Black Death's outbreak, and there is evidence of numerous massacres of Jewish communities in the centuries that followed. The demographic impact of the massacres was that there was a mass exodus of Jews from west to Eastern Europe, to countries such as Poland (where they were actually welcomed by authorities). The consequences of this demographic shift would be most felt six centuries later, when millions of Jews across Eastern Europe were exterminated at the hands of the Nazi regime during the Holocaust.