More than 200 million Christians--or one in 12 worldwide-- are persecuted for their faith.
The most dangerous place for Christians is North Korea, but most of the worst nations for Christians are Muslim.
Open Doors USA's 2017 World Watch List has found that Christian persecution rose globally in 2016 for the third year in a row. The survey is a global indicator of countries where human and religious rights are being violated.
Somalia and Afghanistan were second and third worst.
Pakistan rose to No. 4 and had the overall highest level of violence. Sudan was fifth.
Open Doors says "Islamic extremism remains the global dominant driver of persecution, responsible for initiating oppression and conflict in 35 out of the 50 countries on the list."
Approximately 1,329 churches were attacked or damaged, worldwide.
Afghanistan, Maldives, North Korea, Somalia, Turkmenistan and Yemen are the most dangerous countries to own a Bible, because Christians are killed or put in labor camps if caught with one.
Believers also face torture, beheadings, rape, and the loss of their homes.
David Curry, president and CEO of Open Doors USA, said the list "calculates not only deaths reported in the news, but also persecution at a grassroots level, where family-to-family persecution is tracked."
Open Doors attributed part of the rise in persecution to increased ethnic nationalism in 2016. In unstable political situations, minority Christians are often scapegoated.
"For Christians in the West, the Open Doors World Watch List is a clear indicator that we need to advocate on behalf of those who do not have the same religious freedom privileges we do," Curry said.
He added, "We hope the Trump administration will address religious liberties in the first 100 days in office."