Quill embroidery is usually stitched onto the surface of brain-tanned hide, although other quillworking techniques may use a base of rawhide or birch bark. Very few tools were needed for traditional quillwork. Often the craftsperson kept sorted quills in bag made from the bladder of an animal. To ensure symmetry, quillwork designs were sometimes cut from folded sheets of birchbark or rawhide that were then used as 'templates'. 'Pens' for outlining these designs were often made from flat, sharpened pieces of bone which were sometimes dipped in special stains. Awls needed to pierce the holes were made from ulna bones or other long-bones,antlers sharpened to points, fish bones, and even thorns.

The other tool sometimes included in the quillworkers kit is the quill flattener. Many embroidery techniques require that the air is pressed out of the quill so the resulting work will lay flat. Many traditional quillworkers do not use a flattening tool, preferring the time saving method flattening the quill 'by hand'. With the barbed end of the quills held in their teeth, a quillworker pulled with their thumb and finger down the length of the quill, pinching out the air (without having to put their work down to pick up both quill and flattening tool).

The thread used in embroidery was made from animal sinew from the fibrous tendons along the spines of deer, moose, elk, or buffalo. Sinew thread does not require the use of a needle. Before it's use a length of sinew fiber is split away from soaked tendons, and the tip is rolled between the fingers, creating a point. The single sinew fiber dries within minutes and a stiff point results that is easily passed through the hole made by an awl. The point is left dry, but the remaining length is kept supple and moist with saliva to make secure sewing possible. More rarely, thread was twisted from fibrous plants such as Dogbane (Indian Hemp). Needles are a contemporary tool, needed to accommodate the limp nylon threads used by most quillworkers today.

Soaking quills softens them and makes them more pliable (and less dangerous), similar to what mother porcupines do to make it possible to give birth to their babies. Over soaking the quills will result in weak quills that will stretch and break easily. The ideal way to moisten quills is with saliva, and many 'old time' crafters held the quills in their mouth (barbed end pointing out) much like today's seamstress hold their pins. Once a quill is adequately moistened, (and depending on what the particular technique calls for), the quill is flattened. In order for the air to escape, the tip is trimmed from the quill. Some quillworkers cut off the barbed end, and others cut off the follicle end. A quill can be flattened, and the air pressed out, by placing it against a hard surface and running a smooth hard object over it. Traditional quill flatteners are made of polished bone, antler or wood. Modern flatteners can be metal spoons, rounded plastic objects, or just the back of your thumbnail.

With most embroidery methods (edging techniques are different), the needle (or awl) does not penetrate all the way through the leather. Each tiny stitch is made into the leather just below the work surface, so the quiller does not have to constantly turn the work over. It is important to stitch down each quill quickly, as the quills dry and become stiff very fast. As each stitch is made, the quills are folded in such a way that the thread is hidden (and protected from wear). Quills are short and new ones must be spliced in as the embroidery progresses. When splicing quills, the new quill is usually placed under the end of the old one, although some people insert the barbed end of the new quill into the hollow of the old one. There are several traditional techniques of quill embroidery, and dozens of variations. These are some basic quillwork stitches: line, band or straight, overhand or zig-zag, and sawtooth or rick-rack quilling, not to mention methods used in quill edging, wrapping or loom weaving. By expanding on the basic stitches, different effects can be achieved with diamond, triangular, plaited and checkerboard designs.

An example of fine quillwork will have a shiny, undamaged look, with even rows, uniform with, and tiny, invisible stitches. The dark quill ends should be hidden under the embroidery, unless the black tips are used to create a the pattern. With the best embroidery, unlike the porcupine, there are no pointed or rough projections sticking up when you feel the quillwork with your hand. The key to beautiful, even quill embroidery is in the careful sorting and selection of quills. Although quillwork requires some dexterity and attention, the greatest requirement of all is patience.