The quintessential “high-style” Crazy quilt of the 1880s was a “parlor piece,” usually too small for use as a bedcover, and which included an array of irregularly-shaped patches cut from an astonishing range of luxurious fabrics, such as silks, satins, brocades, velvets, and ribbons. The patches were embroidered, embellished, or painted with various images from nature and popular culture, and their edges were covered with rows of decorative embroidery stitches. In broad terms, these are the elements that define the Crazy style.

In addition to adhering to a style or set of visual characteristics, Crazy patchwork also has an underlying aesthetic—a philosophy of beauty or visual representation. The aesthetic characteristics include rich and varied textures, irregularity and asymmetry, luxurious materials, abundant ornamentation, and something made for the sake of decoration without the necessity of usefulness. Originally a phenomenon of late-Victorian upper and middle class homes, objects that reflect this style or aesthetic in varying degrees—even if made today—may also be considered “Crazy” or "Crazy-like." In fact, Crazy quilts and patchwork items from the 1880s have inspired many other objects from utilitarian bedcovers to contemporary studio-made artworks.

Early Crazy patchwork and quilts were most frequently pieced upon a foundation cloth and then lined, but without batting. They were rarely quilted but were sometimes tied. There were regional variations in construction, however. In the United States, makers tended to make smaller squares of Crazy patchwork before joining them together for an overall Crazy effect.  British Crazy work was rarely constructed in blocks and early examples were highly embellished. Products made specifically for inclusion in Crazy quilts contributed to the look of Crazy quilts in the United States to a greater extent than in the United Kingdom.