In this conceptual article, we illuminate Western building conservation philosophy practice with insights into Eastern conservation philosophy and associated aesthetic understanding. We frame dialogue recognizing individual and societal perspectives on treatments to buildings that attempt to attain “permanence” or “impermanence” in form, fabric, and artifact. Although not expressly sharing origins, Eastern and Western conservation philosophies practically yield commensurate or quasi approaches in intervention. These similarities have not been notably articulated before, and reveal meaningful insights for decision heuristics and guidance fundamental for repair scheme design and intervention. Western, pattern-based views relating to philosophical reasons around the impossibility of perfection, or “correctness” in physical building form resonate with Eastern views supported by Kiku Kiwari. Moreover, universality in acceptance of Western Patina and Eastern Wabi-Sabi, and Eastern Kintsugi and Western legible fabric repair convey overt signals of philosophies beyond technical performance. Moreover, we find Western bias toward “tangibility”, and greater appreciation of “intangibility” in Eastern approaches that are culturally enriching and go beyond mere retention of fabric and architectural form, linking building memory with territory. We suggest potential cross-fertilisation of thinking to create an environment of greater cultural understanding of the motives, thoughts, and practices in East and West.