This paper presents a semi-automated framework for transforming two-dimensional miniatures from medieval manuscripts into three-dimensional digital models suitable for extended reality (XR), tactile 3D~printing, and web-based visualization. We evaluate seven image-to-3D methods (TripoSR, SF3D, SPAR3D, TRELLIS, Wonder3D, SAM~3D, Hi3DGen) on 69~manuscript figures from two collections using rendering-based metrics (Silhouette IoU, LPIPS, CLIP~Score) and volumetric measures (Depth Range Ratio, watertight percentage), revealing a trade-off between volumetric expansion and geometric fidelity. Hi3DGen balances topological quality with rich surface detail through its normal bridging approach, making it a good starting point for expert refinement. Our pipeline combines SAM segmentation, Hi3DGen mesh generation, expert refinement in ZBrush, and AI-assisted texturing. Two case studies on Gothic illuminations from the Decretum Gratiani (Vatican Library) and Renaissance miniatures by Giulio Clovio demonstrate applicability across artistic traditions. The resulting models can support WebXR visualization, AR overlay on physical manuscripts, and tactile 3D~prints for visually impaired users.