Quiltmaking has a long history in West Virginia, often seen as women's work, influenced by cultural and local traditions. West Virginia quilts feature unique patterns, such as "the fans," and may use techniques like hemming instead of binding.

Initially, quilt fabric was expensive, limiting quiltmaking to wealthier people. Before the Civil War, quilts were made with fancy European fabrics, but after the war, cheaper cotton allowed more people to quilt, with patterns like "scrap quilts" becoming popular.

By the late 1800s, the "crazy quilt" style emerged, using random fabric pieces and appealing to less experienced quilters. Today, quiltmaking is celebrated in West Virginia through annual shows, with women's groups using it to raise funds.