This paper traces the historical process through which quilts in the United States came to be recognized as “art quilts” and attained the status of legitimate art. Introduced to the New World by European settlers, quilts developed into a medium that simultaneously embodied utility and aesthetic expression in the daily lives of women. Prior to the Industrial Revolution, quilts were regarded as a refined artistic activity that reflected the aesthetic sensibilities and creativity of upper-class women. However, with the mass dissemination of materials and techniques during the Industrial Era, quilts became increasingly popularized. By the late 19th century, they had come to symbolize values such as thrift and pioneering spirit, establishing itself as an iconic expression of American cultural identity. In the 20th century, efforts to elevate quilts from craft to fine art gained momentum, gradually enhancing their cultural and artistic value. During the 1960s, first-generation feminist artists identified quilts as a potent medium of “feminine” expression and began actively incorporating it into their work. A critical turning point came with the 1971 exhibition Abstract Design in American Quilts, which revealed elements of modernist abstraction in traditional quilts, thereby positioning quilts within the realm of fine art. By the 1980s, large-scale documentation and digitization projects were launched to preserve the quilt heritage, alongside the establishment of museums and research institutes dedicated exclusively to the quilts. Professional organizations were also formed to promote quilt education from an artistic perspective, encouraging both creative production and exhibition activities. These developments culminated in the landmark 1986 exhibition The Art Quilt, which definitively solidified the status of quilts as a recognized art form. As such, quilts have functioned as a significant cultural and artistic medium deeply rooted in the lives of American women. Especially in the latter half of the 20th century, the recognition and institutionalization of quilts as art contributed to the global dissemination and development of the art quilt movement, playing a pivotal role in the ongoing evolution and expansion of quilting as a contemporary art practice.