A patriarchal basilica refers to those churches at Rome ceremonially assigned to one of the Patriarchs. It must be distinguished from the concept of a major basilica which is a canonical class of church which includes four of the five patriarchal basilicas (excluding St Lawrence's) but which has been more generally extended to include any of several churches in which the high altar is reserved to the Pope or his representative.

Originally the "patriarchs" referred to in the title Patriarchal Basilicas were the Latin Rite ceremonial Patriarchs who lived as ornaments of the Papal Court and are now abolished, not the Eastern Patriarchs of those same cities. Later, they came to be associated with the actual Eastern Patriarchs of the same cities, though confusion over the nature of their association with the churches and which of several the Eastern Catholic (or Orthodox) Patriarchs of the same city the title applied to, led Pope Benedict to re-designate the churches "papal basilicas" though the traditional associations with the Five Ancient Patriarchates remain.

The name patriarchal refers to the churches being assigned to one of the patriarchs. There are five patriarchal basilicas:

• San Giovanni in Laterano (St John Lateran, the Pope)
• San Pietro in Vaticano (St Peter's Basilica, Patriarch of Constantinople)
• Santa Maria Maggiore (St Mary Major, Patriarch of Antioch)
• San Paolo fuori le mura (St Paul outside the Walls, Patriarch of Alexandria)
• San Lorenzo fuori le Mura (St. Lawrence outside the Walls, Patriarch of Jerusalem