The Lutheran Church—Missouri Synod and Lutherans from Hong Kong began serving refugees in Macau in October 1950. By 1953, with significant involvement from The Lutheran Hour with rebroadcasts, from Hong Kong, the work continued. In the late 1960s, the Rev. Louis Jasper began work with the deaf in Macau.

The Lutheran Church—Hong Kong Synod (LCHKS), based in nearby Hong Kong, became an LCMS partner church in 1977. The LCHKS serves Lutheran congregations in both Hong Kong and Macau. Today, the LCMS primarily works in Macau through an alliance missionary.