This work considers the final developments and decline of Roman cities in Central Anatolia, an understudied region of the Eastern Empire. The original data collected in the excavation at Pessinus are compared with those of other neighboring cities (Ankara and Amorium) as well as with the general development of local rural communities. The final results show that, after a period of generalized economic and demographic growth (4.-7.th c. CE), Central Anatolia undergoes a period of decline, which leads to the disappearance of most cities (Pessinus) in favor of the few thematic capitals (Ankara and Amorium) and Christian rural sites (Germia).