With the emphasis largely on the text — both for its sacred content and the meritorious and ritually significant act of copying it — the painting of images occupied a secondary position, and the pages themselves often had no illustrations. The insides of the cover panels often bore images, while the outsides were largely painted with decorative floral patterning. For folios that would contain images, the process of painting followed that of writing; images would be painted into spaces measuring roughly 5 x 7 centimetres, allotted to them between columns of text. Illustrated folios commonly held three such images each, equally spaced on the horizontal panels. While the names of the scribe and the donor commissioning the manuscript were mentioned on the colophon, alongside the year and place of the manuscript-making, the artist was never credited in these manuscripts. 

Moreover, the paintings in the manuscripts do not directly illustrate the texts they accompany, instead serving as iconic representations of principal Buddhist themes. They are largely restricted to depictions of events from the Buddha’s life, specifically the Eight Great Events, which were canonised in the region by the ninth century — the Buddha’s birth; enlightenment; first sermon; acceptance of honey from a monkey at Vaishali; taming of Nalagiri the elephant; descent from the celestial plane Tavatimsa heaven; multiplication of himself at Shravasti; and death. Deities of the Mahayana as well as the Vajrayana sects, such as Tara, Maitreya, Lokanatha, Marichi and Vajrapani, are also found in the manuscript paintings.

The figures in the paintings typically show strong silhouettes and a clear definition of forms. Initiated with black or red outlines, they are painted in with layers of flat colour. Backgrounds are rendered in flat colours, with the figures occupying a single plane. Tonal variation and contours are achieved by overlaying progressively darker tones in different areas of the figures, creating a degree of modelling. Finally, forms and facial features are emphasised with black outlines. A hierarchy between the deity and the devotees is established through their relative positions and sizes in the composition. Whilst the Buddha’s face is represented frontally, others are usually depicted in three-quarter profile.

The colours were derived largely from mineral sources — white from burnt conch shells, yellow from orpiment, blue from lapis lazuli, and vermilion from cinnabar. These, along with green pigment, crimson from madder root, and black from soot, formed a palette that corresponded with the Buddhist iconographic conventions of the time.

The manuscript paintings made during the reigns of Mahipala (r. 988–1038) and Nayapala (r. 1038–55) constitute an early phase of the tradition, known for its close association, and even imitation, of the ideals of mural paintings of the period. The figures of this phase are relatively flat and angular, with delicate lines, and features such as the eyes exaggerated in proportion to the face. The paintings of this period, executed in subdued colours, also featured crowded compositions with multiple figures occupying the frame. 

From the late eleventh century onwards, around the period of the rule of Ramapala (r. 1077–1120), manuscript painting entered its mature phase, with more spacious compositions and greater fluidity of figural forms. This phase is marked by a distinctive emphasis on the fullness and suppleness of the figure, especially in the representation of female deities, and more saturated colours. Scholars have also pointed to two regional variations in the paintings of this phase. The paintings executed closer to the Pala capital in the Magadhan centres of modern-day Bihar, such as Nalanda, constitute the northern style, also known as the Varendra style — characterised by bold, hard lines and ornate compositions. They sometimes depict figures of donors or patrons and their family members painted along the periphery of the main illustration panels. The manuscripts here employed the formal Siddhamatrika Brahmi script also known as Ranjana or Kutila (‘hooked’ or ‘crooked’, referring to the shape of the letters). 

The southern — or Vanga style — was centred around present-day Munshiganj district of Bangladesh, the capital of the Yadava-Varman dynasty, which by this time sought peace with the Palas. It is known for the simplicity of its pictorial style, minimal decorations and bold application of tonally flat colours. Vanga manuscripts were written in a proto-Bengali Gaudiya script, rather than the Kutila script preferred in the north. The difference between two extant Prajnaparamita manuscripts — produced eleven years apart in the eleventh and twelfth centuries, under the Yadava-Varman ruler Harivarmadeva — demonstrate the stylistic shift between the early and late phase. 

Pala manuscript painting traditions declined towards the end of the twelfth century, when Turkic rulers began to establish their rule over present-day West Bengal, Bangladesh and parts of Bihar. However, the dissemination of Buddhism ensured that some of Pala manuscripts travelled to Nepal, Tibet, Kashmir in South Asia and Thailand in Southeast Asia, where they inspired local adaptations of the style in murals and manuscripts. The Bharat Kala Bhavan and The Asiatic Society of Bengal hold some Pala manuscripts, particularly of the Prajnaparamita Sutra, dating back to the eleventh and twelfth centuries.