Cross-stitch is one of the oldest forms of embroidery and can be found all over the world. Many folk museums show examples of clothing decorated with cross-stitch, especially from continental Europe and Asia.

Two-dimensional (unshaded) cross-stitch in floral and geometric patterns, usually worked in black and red cotton floss on linen, is characteristic of folk embroidery in Eastern and Central Europe.

In the United States, the earliest known cross-stitch sampler is currently housed at Pilgrim Hall in Plymouth, Massachusetts. The sampler was created by Loara Standish, the daughter of Captain Myles Standish, circa 1653.

Multicoloured, shaded, painting-like patterns as we know them today are a recent development, deriving from similar shaded patterns of Berlin wool work of the mid-nineteenth century.

Traditionally, cross-stitch was used to embellish items like dishcloths, household linens, and doilies (only a small portion of which would actually be embroidered, such as a border). Although there are many cross-stitchers who still employ it in this fashion, especially in Europe, it is now increasingly popular to simply embroider plain pieces of canvas and hang them on the wall for decoration.

There are many cross-stitching "guilds" across the United States and Europe which offer classes, collaborate on large projects, stitch for charity, and provide other ways for local cross-stitchers to get to know one another.

Today cotton floss is the most common embroidery thread. It is a thread made of mercerised cotton, composed of six strands that are only loosely twisted together and easily separable. Other materials used are pearl cotton, Danish flower thread, silk and Rayon. Sometimes different wool threads, metallic threads or other speciality threads are used, sometimes for the whole work, sometimes for accents and embellishments.