"Quilting" specifically refers to the stitches that hold the layers of a quilt together. This typically is one of the last steps in assembling a quilt. Historically, quilting was accomplished with the top, filling, and back basted or pinned together and then stretched into a frame, which might take up a whole room. A quilter could also stitch away without the quilt stretched, or stretch it in a large embroidery hoop.

Prior to the development of the sewing machine, quilting was always done by hand, usually with a small running stitch. Once consumers had access to sewing machines, some experimented with machine quilting utilizing a machine quilting attachment made available in the early 20th century. Machine quilting did not catch on in a significant way until recent decades. Now many quilters use special large sewing machines called “long arms” to complete the quilting process.

Instead of quilting, some pieced or appliqued bedcovers are tied with yarn or other thread. Historically tying was common on Log Cabin and Crazy quilts. Tied bedcovers are often called quilts, although they are also referred to with various regional names including comforter, comfort, comfortables, haps, and puffs.