The Middle East region had one of the most vibrant economies in the world from the eighth until the end of the eleventh centuries. This chapter first examines the evolution of institutions in the region in three different areas, land regime, private finance, and public borrowing, to show there were many changes over the millennium from the rise of Islam until the modern era. While these were often in response to the changing circumstances, they also reflected the social structure and prevailing power balances in these societies. The chapter then argues that how towns and urban areas related to the state, how urban areas are included in state policies, and how they influenced the shaping of institutions are the keys to understanding long-term institutional and economic change in the region. The political configuration and the related institutions persisted into the modern era.