With no pattern to follow, the Crazy quilt arguably offered the maker more artistic freedom than other types of patchwork. Other than trying to incorporate as many fabrics and different types of embellishment as possible, there were no rules. From selecting and arranging the fabrics to deciding which stitches and embroidery to incorporate, the maker controlled the outcome. As high-style Crazy quilts were extremely labor intensive, the amount of embroidery and embellishment added to Crazy work likely correlated with the amount of leisure time the maker had.

Often a figurative element, maybe flowers or a house, forms a central focus in a quilt, reminiscent of sampler layouts.

American Crazy quilts were frequently, though not always, organized in blocks, often completed with the addition of a wide border. These borders were sometimes left plain, but often were embroidered with garlands of flowers. Evidence of pattern marking has been found on some of these embroidered borders. Frilled (ruffled) borders were also used in both the United States and the United Kingdom. Occasionally, lace borders have been added, but this seems slightly more common in the United Kingdom.

In the United Kingdom, it appears the patches were more commonly arranged in an all-over pattern, but it is often possible to see where large sections of Crazy work have been put together and the joins disguised.

On occasion, just sections of Crazy work can be found in mosaic and other quilts, maybe as a nod to fashion.

No two Crazy quilts look the same, though with the proliferation of instructions, advice, and kits that became available in the US in the late nineteenth century, a certain "look" can be detected in some surviving examples.

One unusual manifestation dates from the first few decades of the twentieth century. A few coverlets made in the crazy technique but executed in just the one fabric have been discovered. Their makers were possibly following the Art Deco decorative trends.