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What is patchwork? Patchwork or 'pieced work' is a form of needlework that involves sewing together pieces of rugs into a larger design. The larger design is usually based on repeat patterns built up with different colored shapes. These shapes are carefully measured and cut, straight-sided, basic geometric shapes making them easy to piece together. Precise joining makes for patchwork that lies flat without puckers. A hugely popular concept today, available in antique or modern formats, and exquisite tones of color.