Recent work in Middle English literature addresses the emerging relationship between formal analysis and book history. This article, emerging from the 2009 Conference on Editorial Problems in Toronto, seeks to clarify the way in which formalist approaches intersect with trends in English literary manuscript studies. How, we ask, can the lively field of book history take new direction through contact with the ‘new formalisms’ articulated in literary studies? More precisely, how does the form of the medieval book produce literary meaning in a distinctive and historicizable manner? We explore critical approaches to the formal features of medieval manuscripts, addressing medieval and modern theories of the book’s form, the relationship between written and oral forms of texts, the dialect of scribes, authorial composition of manuscripts, scribal corrections, the layout and illustration, and the binding of the codex. We suggest that close readings of manuscript form can shed light on aspects of texts obscured by the printing technology and formatting changes of modern editions. Furthermore, we point to new avenues for contextualizing the book within late medieval literary culture.