Although manuscript digitalization helps to safeguard old manuscripts, the challenges of old manuscripts' preservation remain present. Old manuscripts are increasingly neglected and hard to access. This study aims to shed light on the preservation of manuscript contents as it is being done through various digitalization programs by a variety of national and international institutions in Indonesia. This study found that, paradoxically, the availability of many digital manuscripts does not enhance the study of their contents. Similarly, attention to the physical preservation of these manuscripts has also not seen a significant improvement. By using philological, codicological, and anthropological approaches, this study gives contribution to enhance the understanding on the needs of manuscript digitalization as an integral effort to preserve their contents and physical preservation. © 2022 Walter de Gruyter GmbH, Berlin/Boston.