After the 1971 article of G. Geraci, which gathered together the extensive evidence for Egyptian proskynemata, the practice of proskynema from a regional perspective has not attracted much scholarly attention. The present article presents and studies the documents relating to pilgrimages to Sarapis from the Hellenistic to the Imperial periods. It also places emphasis on the linguistic usage and the variations of the proskynema-expressions as well as their local character. From this analysis Abydos appears as the major centre of pilgrimages to Sarapis. The graffiti carved on the walls of the Memnonion present a lively picture of the activities of pilgrims: they visit the temple, which functions as a dream-oracle, mostly seeking healing or thanking the god for previous successful cures. Pilgrimages to Sarapis left traces of their presence (primarily dedicatory inscriptions) also at the Kharga Oasis, at Philae and as far as Lower Nubia. The literal proskynema to the Sarapieia of Egypt should be associated with the proskynema-formula that was used in letters from at least the 2nd century CE. The formula, which indirectly pertains to the literal practice of proskynema, is understood as an expression of affection towards and interest in the recipient. Finally, concerning the evolution of the Sarapis cult in general, the proskynema-evidence confirms the image of Sarapis as a major saviour god and as a personal god, to whom his adherents felt considerably attached.