Roy's research and over 100 publications focus on the economy of Gaza and more recently on the Palestinian Islamic movement. Reviewing her 2007 Failing Peace: Gaza and the Palestinian-Israeli Conflict, Bruce Lawrence writes that "Roy is the leading researcher and most widely respected academic authority on Gaza today." She has also studied Palestinian politics and the broader Israeli–Palestinian conflict.
Roy spent time doing dissertation fieldwork in Israel and in the Gaza Strip as a research assistant to the third West Bank Data Base Project. This was a non-official survey led by Meron Benvenisti, whose goal was to examine the impact of Israel's national unity coalition government on the West Bank and to a lesser extent the Gaza Strip. Roy prepared a background paper about the Gaza Strip for the Project in 1986, before submitting, in 1988, her doctoral thesis entitled Development under occupation: a study of United States government economic development assistance to the Palestinian people in the West Bank and Gaza Strip, 1975-1985.
Roy is also the author of The Gaza Strip Survey (1986) and The Gaza Strip: The Political Economy of De‐development (1995, 2001), now in its second edition with a third edition forthcoming. She is the editor of The Economics of Middle East Peace: A Reassessment (1999). Her 2011 study of Hamas, political Islam and the Islamic social sector in Gaza won a 2012 British-Kuwait Friendship Society Prize in Middle Eastern Studies.
Roy's work has appeared in the Journal of Palestine Studies, Current History, Middle East Journal, Middle East Policy, International Journal of Middle East Studies, The Beirut Review, American Political Science Review, Critique, Journal of the American Academy of Religion, Chicago Journal of International Law, Index on Censorship, La Vanguardia, Le Monde Diplomatique and the London Review of Books, as well as in The Lancet.
Roy has served on the Advisory Boards of American Near East Refugee Aid and the Center for American and Jewish Studies at Baylor University and on the Board of Directors of the Gaza Community Mental Health Program - U.S. branch.
In addition to her academic work, Roy has served as a consultant to international organizations, the U.S. government, human rights organizations, private voluntary organizations, and private business groups working in the Middle East.
Roy stated that "the Holocaust has been the defining feature of my life" as part of the Second Annual Holocaust Remembrance Lecture, which she delivered to the Center for American and Jewish Studies (now Center for Jewish Studies) and the George W. Truett Theological Seminary at Baylor University. Roy had been invited by founding director Marc H. Ellis to connect her family's experience in the Holocaust to her academic work on the Palestinian people.
Roy explained that both her parents had survived the Holocaust, but that 100 members of her extended family, who had resided in the Jewish shtetls of Poland, had been killed. Her father, Abraham, was one of the two known survivors of the Chelmno extermination camp, while her mother, Taube, survived Halbstadt (Gross Rosen) and Auschwitz. Having visited Israel many times when she was growing up, she added, "[i]t was perhaps inevitable that I would follow a path that would lead me to the Arab-Israeli issue", providing several examples of parallels between Nazi treatment of Jews and Israeli soldiers' treatment of Palestinians which, in her opinion, "were absolutely equivalent in principle, intent, and impact: to humiliate and dehumanize."
She further developed these themes in the 2008 Edward Said Memorial Lecture at Adelaide University, in which she commented that "Israel’s occupation of the Palestinians is not the moral equivalent of the Nazi genocide of the Jews. It does not have to be. The fact that it is not in no way tempers the brutality of the repression, which has become frighteningly normal. Occupation is about the domination and dispossession of one people by another. It is about the destruction of their property and the destruction of their soul. At its core, occupation aims to deny Palestinians their humanity by denying them the right to determine their existence, to live normal lives in their own homes. And just as there is no moral equivalence or symmetry between the Holocaust and the occupation, so there is no moral equivalence or symmetry between the occupier and the occupied, no matter how much we as Jews regard ourselves as victims".
Roy was born and raised in West Hartford, where she attended Hall High School (Connecticut). She received her undergraduate degree from Harvard College. She currently resides in Boston, Massachusetts.
Roy drew public attention when a book review she had written of Mathew Levitt's book Hamas: Politics, Charity, and Terrorism in the Service of Jihad was rejected by Tufts University’s The Fletcher Forum of World Affairs. After the editor-in-chief accepted the piece, he wrote to inform Roy that the article had been reviewed for "objectivity," and that "all reviewers found the piece one-sided" and then rejected it, but apologized "for the way in which this process was carried out." Middle East Policy later published the review with Roy's note on the affair which described the rejection as a "blatant . . . case of censorship."
- Hamas and Civil Society in Gaza: Engaging the Islamist Social Sector. Princeton: University Press. 2011. ISBN 978-0-691-12448-3.
- Failing Peace: Gaza and the Palestinian-Israeli Conflict. London: Pluto Press. 2006. ISBN 978-0-7453-2235-3.
- Research in Middle East Economics, Volume 3. The Economics of Middle East Peace: A Reassessment. JAI Press. 1999. ISBN 978-0-7623-0410-3.
- The Gaza Strip: The Political Economy of De-development. Beirut: Institute for Palestine Studies. 1995. ISBN 978-0-88728-260-7.
- The Gaza Strip: A Demographic, Economic, Social and Legal Survey. Westview Press. 1986. ISBN 978-0-8133-0474-8.
- "Praying with Their Eyes Closed: Reflections on the Disengagement from Gaza". Journal of Palestine Studies. 34 (4): 64. 2005. doi:10.1525/jps.2005.34.4.64. Archived from the original on 2012-06-06.
- "The Gaza Strip: A Case of Economic De-Development" (PDF). Journal of Palestine Studies. 17 (1): 56–88. 1987. doi:10.1525/jps.1987.17.1.00p0144f. Archived from the original (PDF) on 2013-05-13.
- "Sara Roy". Center for Middle Eastern Studies. Retrieved 2008-02-18.
- Lawrence, Bruce B. (2007). "Roy: Failing Peace: Gaza and the Palestinian-Israeli Conflict (review)". Journal of Palestine Studies. 37 (1): 111. doi:10.1525/jps.2007.37.1.111. Archived from the original on 13 February 2012. Retrieved 29 July 2012.
- "Sara Roy, From Oslo to the Road Map". Committee for a Just Peace in Israel and Palestine. March 2004. Retrieved 2008-02-18.
-  Archived November 25, 2005, at the Wayback Machine.
- The Gaza Strip: a demographic, economic, social and legal survey
- Development under occupation: a study of United States government economic development assistance to the Palestinian people in the West Bank and Gaza Strip, 1975-1985[dead link]
- Hamas and Civil Society in Gaza: Engaging the Islamist Social Sector by Sara Roy. Princeton University Press website. Retrieved 29 July 2012.
- "Health services in Gaza under the autonomy plan". Lancet. 343 (8913): 1614–7. June 1994. PMID 7911926. doi:10.1016/S0140-6736(94)93063-5.
- Roy, Sara (1 March 2012). "Gaza: Treading on Shards". The Nation. Retrieved 29 July 2012.
- Adam Shatz (2004). Prophets Outcast: A Century of Dissident Jewish Writing About Zionism and Israel. Nation Books. ISBN 1-56025-509-9.
- Roy, Sara (Fall 2002). "Living with the Holocaust: The Journey of a Child of Holocaust Survivors". Journal of Palestine Studies. Institute for Palestine Studies (125). Archived from the original on 2011-06-14. Retrieved 2008-12-28., reprinted in Shatz, Adam (2004). Prophets Outcast: a Century of Dissident Jewish Writing About Zionism and Israel. NationBooks. pp. 343–356. ISBN 978-1-56025-509-3.
- Roy, Sara (October 2008). "The Impossible Union of Arab and Jew: Reflections on Dissent, Remembrance and Redemption" (PDF). Edward Said Memorial Lecture. University of Adelaide. Retrieved 2009-10-17.
- Roy, Sara (June 2007). "Review of Hamas: Politics, Charity and Terrorism in the Service of Jihad by Matthew Levitt". Middle East Policy. 14 (2): 162–166.