In 1916 The Rev. Walter Lowrie found himself visiting prisoner of war camps throughout Italy, giving aid to Austrian prisoners. He reports that they were 'kindly and generously treated' and that through contributions from the American YMCA he was able to provide them with employment and recreation.

The following year he began doing work that the Red Cross later took up. At that time he was the only English speaking Protestant minister in Rome, even when there were hundreds of servicemen here. After Caporeto, there were refugees to be provided for, and when the war was over, orphans. Lowrie at that time directed the American charity disbursements, and says that he had the privilege of disbursing for all sorts of relief more than $20,000. In 1926 he writes "As a parish we still feel the effects of the war, and this long experience prompts me to wish that by a small endowment we might be protected against disaster. I am not anticipating another universal war: a temporary lull of tourist traffic might leave us stranded for a time. For the stable colony is now smaller than it was fifty years ago...'

During the troubled years 1930-1940 St. Paul's was under the rectorship of four men, until Italy entered the Second World War in 1940 under Mussolini. At this time St Paul's was closed and placed under the protection of the Swiss Legation in Rome. It reopened as a chaplaincy in 1943 for the use of American troops: the pews which are still in use today were built by the quartermaster corps from a stockpile of pineboards.

The work of reconstruction following the war fell to the lot of The Rev. Hillis Duggins: a work of reorganization and repair after the neglect of the war years, a work of stabilizing the financial situation and rebuilding the congregation.

No major changes were attempted then until the rectorship of The Rev. William Woodhams. The first sign of change was the opening of the basement (now used by AA) as an Artists and Students Center, a place for theater, poetry readings, experimental cinema. Partitions were put up to make gallery walls for art exhibitions. And later at the weekends the crypt became a place for American teenagers to hang out. "[Woodhams] said it was important for them to know the church valued their interests so that when they had questions about meaning, the church would be one of the places they would look for answers They needed a place to seem bad without having to be really bad - so the dark crypt, loud music and all the shimmying to 'Hang on Sloopy'...filled the bill." (Brian Williams)

Adapted from St Paul's-Within the Walls, Rome, by Judith Rice Millon

After the teen center collapsed began to be used for refugees and foreigners until the official opening of the Joel Nafuma Refugee Center in 1984. Also in the eighties the basement was given over to Alcoholics Anonymous and related groups, a ministry which still continues to grow today.