In this article, we provide an update on the progress of the AHRC-funded Syriac Galen Palimpsest Project, which is directed by Peter E. Pormann at the University of Manchester. We also present a newly identified folio from Book 3 of Galen’s On Simple Drugs—a book hitherto not known to be represented in the manuscript. We offer some preliminary conclusions about the original medical manuscript’s codicological structure, particularly the composition of its quires and the sequence of hair and flesh sides of parchment. Finally, we outline our approach to analysing the undertext’s palaeography, with reference to the methodology devised by Ayda Kaplan.