Some 380 million Christians are living in contexts of persecution and discrimination for their faith, according to Open Doors.
The Christian organisation published its annual World Watch List on Wednesday, ranking North Korea as the worst country in the world for the persecution of Christians - the same spot the hermit communist country has occupied for the last two decades.
Despite terrifying reprisals for being a Christian - including execution and imprisonment in labour camps - Open Doors estimates there are between 300,000 and 500,000 Christians in North Korea.
"It is almost impossible for these Christians to gather for worship. For those who dare to meet, utmost secrecy is essential for their survival," says the report.
"If discovered by the North Korean government, Christians face deportation to a political prison camp, hard labour or execution. Sharing one's faith or bringing religious literature into the country may lead to detention and forced labour."
China - which itself ranks 15th on the list - is accused of being "complicit" in "crimes against humanity" for forcibly repatriating hundreds of escapees to North Korea with no concern for the fate they face upon their return, including reports of torture and imprisonment. The repatriated escapees who have converted to Christianity are treated more severely, Open Doors said.
The report says that authoritarianism is growing across Central Asia where it citizens are subject to "excessive state surveillance", and there are restrictions on Christian gatherings.
Even in countries where Christians are the majority there can be discrimination, with the authorities in Nicaragua and Cuba targeting Christians and churches that criticise them.
In some countries, worship gatherings are being disrupted by extremists or vigilantes, and in other places, like Algeria, Christians who want to attend church are being forced to register with the authorities.
2024 also saw the "rapid" rise of digital persecution.
"New technology is allowing authoritarian governments (especially China) to restrict Christian communities through surveillance and censorship," the report says.
"This has only intensified due to the growth in artificial intelligence (AI). Elsewhere, extremists are using drones in their attacks or are policing what Christians may say on messaging apps.
"The implications for freedom of religion or belief are only now beginning to be discussed."
In the last year, violence against Christians has intensified across 15 sub-Saharan countries, triggering a "displacement crisis". The report attributes the increase to Islamist extremists capitalising on government instability.
Persecution is on the rise in Burkina Faso (20th), Mali (14th) and Chad (49th), which entered the top 50 for the first time. In Nigeria (7th), Christians face "extreme" persecution.
"The Sahel region of Africa has become a hotspot for forced displacement, with Nigeria at the epicentre," Open Doors said.
"Radical Islamist violence in Nigeria has been a factor in driving more than three million people from their homes, and the terror group Boko Haram has begun using drones to hunt down Christians who are fleeing for their lives."
