Eastern Catholic churches affirm the same seven sacraments as the Latin Church (Baptism, Chrismation/Confirmation, Eucharist, Penance, Holy Orders, Matrimony, Anointing of the Sick) but administer the sacraments of initiation together and in a distinctive sequence. A person—including an infant—is baptized (typically by triple immersion), immediately receives Chrismation (the Eastern form of Confirmation), and then receives Holy Communion. This unified initiation reflects the ancient practice of the undivided Church.

The Eucharist is the heart of Eastern Catholic worship, celebrated through the Divine Liturgy (most commonly that of St. John Chrysostom or St. Basil the Great). The Eastern tradition affirms the Real Presence of Christ in the Eucharist, using the term 'metabole' (transformation) rather than the Latin 'transubstantiation,' though the doctrinal content is understood to be equivalent. The icon screen (iconostasis), liturgical chant, incense, and rich visual symbolism are integral to sacramental worship.