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Patchwork needlework has been around since people have been wearing clothes. Instead of throwing away an article of clothing if it got a hole, it would be mended by sewing a patch over it.

If you mean patchwork quilting, that was a "craft" which became popular in North America during the pioneer days. Women would use good parts from clothing that was too worn out to be mended and/or leftover scraps from previously sewn garments and created quilt tops made from these pieces. They got very creative in developing quilt patterns and made a quilt top of these pieced bits of fabric cut in various shapes of different colors to make specific patterned quilt blocks. Another pattern would emerge when all the blocks were sewn together to make one big piece of fabric to use as a blanket when layered with another large piece of fabric the same size and usually some batting sandwiched in between the quilt top and bottom. To keep all the layers together, plain straight stitches were sewn through all three, usually following around the edges of shapes within the pieced blocks. Then a binding was sewn around the edges to finish the quilt which made a very nice warm blanket. Many block patterns were created and given names like "Ohio Star" and "Flying Geese" which are still popular today in the art of patchwork. Scrap quilts are still made today too (mostly from leftover quilt projects), but most are planned designs with pieces cut from new fabric purchased solely for making a patchwork quilt.

This type of quilting had its beginnings in Europe and there are quilts dating back to the 1700's or even earlier. Most of these were "crazy quilts" that were pieced in no particular pattern and made from different shapes and fabrics. They were often very elaborate with fabrics like velvet and satin stitched together with fancy embroidery in contrasting colors. Those are rare and if found, they are a treasure. They were made as a needlework project as opposed to the pioneer quilts which were made out of necessity. The pioneer quilts are the main inspiration for the popular craft of today's patchwork quilts.

All patchwork is not a quilt, sometimes the pieced fabric was used as a tablecloth, pillow, or even made into clothing. the Biblical Joseph's "coat of many colors" was most likely a form of patchwork, as well as Dolly Parton's childhood "coat of many colors" made by her mom out of necessity.

I've also seen Chinese garments that are hundreds of years old that were made from pieced fabric (not patchwork, but as a design element) and quilted. They were elaborate kimonos quilted with real gold thread and worn by royalty. The Chinese peasants also wore quilted garments for warmth. The knights wore quilted garments (which may have been pieced) under their armour to protect their skin. Pieced fabric has even been found in Egyptian tombs and some Chinese patchwork dates back to 5,000 years.

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