Modern historians concur that the actual circumstances of the plague of Amwas are not reconstructable and largely focus on the descriptions of the event in the 8th–10th-century Islamic histories and collections of hadith (traditions and sayings of Muhammad) in the context of theological debates on predestination, the status of Muslim sinners, and contagion.^[20] The plague of Amwas received more attention in medieval Arabic literature than any other epidemic until the 14th-century Black Death.^[40] Representations of the plague by the sources were "varied and contradictory", according to the historian Justin K. Stearns.^[20] The narratives of the response to the plague by Muhammad's companions Umar, Abu Ubayda, Amr and Mu'adh informed Muslim religious and legal interpretations of plague throughout the Middle Ages, including the response to the Black Death.^[14][20]

Medieval Muslim scholars derived three principals from the contemporary reactions to the plague of Amwas: the first was that the plague was a form of divine mercy or martyrdom for the Muslim faithful and a punishment to non-believers; the second was the prohibition on Muslims entering or fleeing plague-stricken lands; and the third was the plague was not a contagion, rather it was directly imposed by God.^[14] The tenets consistently caused theological disagreements throughout the epidemic recurrences of the Middle Ages as a result of the difficulty in accepting plague as divine mercy or punishment and observable contagion.^[14]

In the assessment of Dols, native Christian and Jewish attitudes and natural human anxieties likely influenced aspects of the first principle, namely that plague represented divine punishment or warnings. Muslims in this camp related the plague to lax morals among the Muslim troops in Syria, such as the consumption of wine, which supposedly led Umar to order the lashing of drinkers. On the other hand, the interpretation of plague as mercy or martyrdom is evident in Abu Ubayda's speeches to the troops at Amwas and in the council at Sargh.^[14] A poem about the plague of Amwas recorded by the Damascene historian Ibn Asakir (d. 1175) reflects the martyrdom belief:

How many brave horsemen and how many beautiful, chaste women were killed in the valley of 'Amwas
They had encountered the Lord, but He was not unjust to them
When they died, they were among the non-aggrieved people in Paradise.
We endure the plague as the Lord knows, and we were consoled in the hour of death.^[41]

On the principle of predestination, the events of Amwas were used to argue that whether a person fled or remained in a plague-affected area their death had already been decreed by God.^[18] During an episode of plague in the Iraqi garrison city of Kufa, the prominent statesman and scholar Abu Musa al-Ash'ari (d. 662) turned away visitors to his home due to someone in his household having the plague, and he justified Muslims fleeing plague on the basis of Umar's actions at Sargh.^[18] According to Dols, this also implied a recognition of contagion despite the contradiction with the purported hadith rejecting contagion as a pre-Islamic theory.^[18]