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A shaken Pope Benedict has said Christmas Eve Mass in St Peter's shortly after being knocked over by a spectator who jumped a barrier.
The woman, said to be mentally unstable, managed to grab him by his vestments near the neck area as a security guard tried to overwhelm her.
The Vatican said she had made a similar bid to jump at the Pope last year.
French Cardinal Roger Etchegaray, 87, was standing a few metres away and fell and broke his leg during the incident.
Proceeding with the Mass, Benedict looked shaken and stumbled over some words.
The service in the Vatican started two hours early because officials did not want the pontiff, 82, to get tired.
As members of the 1.1-billion Catholic community celebrated Christmas around the world, thousands of pilgrims gathered in Bethlehem where Latin Patriarch Foud Twal, the most senior Roman Catholic cleric in the Holy Land, said the region's aspiration of peace remained out of reach.
"The wish that we most want, we most hope for, is not coming," he said after passing into Bethlehem in a traditional holiday procession from nearby Jerusalem.
"We want peace."
Repeat incident
The incident involving the Pope lasted only a few seconds and was caught on camera by at least one eyewitness.
Dressed in a red hooded sweatshirt, the attacker leaped over the barrier towards the Pope, prompting gasps from the crowd.
"All of a sudden this person sort of flew over the barricade and the Holy Father went down and all of a sudden all the security people were all on top of it, you know the whole pile there, getting her off and pulling him back up," eyewitness MaryBeth Burns, a US tourist, told the Associated Press.
Security officials rushed down the main aisle to detain the woman, who was later arrested by police.
Her name was not immediately known but the Vatican confirmed she was the same person who had tried to jump a barricade to get close to the Pope at the same service last year.
The Pope had to be helped up by the master of ceremonies at his side, the BBC's David Willey in Rome says.
The theme of his homily was selfishness which, he said, "makes us prisoners of our interests and our desires".
The Vatican said earlier that the decision to move the midnight Mass to 2200 (2100 GMT) was "to make Christmas a little less tiring for the Pope, who has many engagements".
The pontiff earlier appeared briefly at nightfall at the window of his studio to light a candle in a sign of peace.
Tourism boom
In Bethlehem, festivities began with a traditional boy scout band and ended with midnight Mass in St Catherine's Church, next to the Church of the Nativity.
Arriving in Bethlehem, the Latin Patriarch said people in the region wanted freedom of movement.
"We don't want walls, we don't want separation fences."
Addressing worshippers, he added: "[This land's] inhabitants are brothers who see each other as enemies.
"This land will deserve to be called holy when she breathes freedom, justice, love, reconciliation, peace and security."
The Mass was said next to the church built over the stall where Mary is believed to have given birth to Jesus.
Some 300 Christians over the age of 35 from the Gaza Strip were given permission by the Israeli military to leave the territory and come to Bethlehem for 24 hours to celebrate Christmas.
A total of 15,000 tourists are expected in the town during this period, in a year that has seen a record number of visitors - some 1.6 million.
Source: BBC
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