It is the 12th year in a row that North Korea has been ranked as the single most anti-Christian country in the world.
With between 50,000 and 70,000 Christians in the county's concentration camps, labour camps, prisons, or prison camps, it could be regarded as something of a miracle that there are still an estimated 400,000 believers in the North Korean underground church.
Under the brutal and oppressive reign of the Kim family, Christians have been singled out for harsh punishments and imprisonment.
The punishment for owning a Bible or even just being found with one is either execution or a lifelong prison sentence.
On occasion, such a judgement can even become a multi-generational punishment, with prisoners being forced into arranged marriages by the guards and any resulting children also being imprisoned. It is reportedly often the case that only the third generation of prison children will get to see freedom.
This year's list has been described by Open Doors USA President/CEO Dr. David Curry said the issue of persecution was routinely ignored by the international community despite the fact that "Christians are the largest persecuted minority in the world".
The list is based on how free Christians are to practise their faith in the spheres of private, family, community, national and church life. In addition, there is a sixth sphere measuring the degree of violence present in the country. The spheres are all counted equally, with an aim to highlight structural persecution, rather than specific incidents.
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Dr Ronald Boyd-MacMillan, head of Strategy and Research for Open Doors International, said, "It is our intent through the WWL to encourage more people and organisations to carefully study the needs and stories of persecuted Christians, and as a result deepen the passion to pray for them.
"The WWL is more than a set of numbers. It must also be seen as a human document, reflecting millions of sad but also amazing stories of strong faith."
The top ten countries on the list represent the shift of world events and what has been happening to Christians globally over the past 12 months.
For the first time in the history of the list, a sub-Saharan country - Somalia - is second, a position previously held by Saudi Arabia).
Somalia is in part controlled by 'moderate' Islamists, most notably in the capital city of Mogadishu. However undercover surveillance permeates the society looking for apostates that have converted away from Islam to Christianity, meaning the Church has to function in secret.
Outside of the government controlled regions, Somalia is largely ungovernable, with the Islamist militant movement Al-Shabaab either committing horrific feats of violence as they withdraw, or attempting to impose harsh Sharia law where they hold ground.
A large jump on the list is Syria, which moved from 11th position in 2013 to third in 2014. The war is continuing and international efforts to intervene are increasingly hampered by an inability to see a side they can reasonably support while being sure that they serve the best interests of the country.
Syria has more martyrs than any other nation on this list, with 1,213 Christians dying for their faith, most at the hands of Jihadist groups. During the most recent period, more Christians were killed in Syria in all of 2013 than were killed globally in 2012.
Other countries of note include:
• Pakistan – 8th – with the devastating bombing of All Saints church in Peshawar and the open courting of anti-Christian Taliban groups by prominent politicians
• Central African Republic – 16th – the Seleka Islamist rebels have been running riot across the country after supporting a successful coup. Christians are among their primary targets, but God's people are also under attack from foreign fighters joining the conflict from Sudan and other parts of Africa.
• Colombia – 25th – kidnapping by rebel groups such as the FARC have seen a substantial rise in the last 12 months
• Sri Lanka – 29th – a strident Buddhist nationalist movement has been responsible for over 50 attacks on Churches in the past year alone. There is also large amounts of social pressure from local communities and collectives of monks.
The list confirms that the single largest systemic perpetrator of Christian persecution worldwide is fundamentalist Islam, with the most dangerous region being the Sahel region of Northern Africa, a semi-arid area extending from Senegal on the Atlantic coast eastward to Sudan and the Red Sea. In this area, one fifth of the world's Christians coexist with one seventh of the world's Muslims.
The list also reveals that the number of Christians killed for their faith has doubled in the last year. According to Open Doors, some 2,123 Christians were reported to have been killed during the 12 months prior to October 31, 2013. This compares to 1,201 in the previous 12 months.
The World Watch List emphasises that this is the "very, very minimum" count – only those who have been documented as killed.
"Christians aren't always directly killed, but are so much squeezed with regulations and vulnerabilities that they just perish – not at once, but in the course of years," said Open Doors.
"If we would include them in the counting, it would be an enormous number of people. However, the precise number of Christians who die due to these factors is very difficult to quantify."