In Europe during the Middle Ages, pattens were heeled overshoes that both men and women would slip on before heading out. The heels, which were usually wooden-soled, could elevate the foot above the grime at street level – as sewage systems and water pipes weren't a feature of medieval towns, it was common to throw garbage and human waste into the streets. In the 15th century, leather pattens became fashionable and in London, a wealth of new styles emerged including multi-layered leather soles, ones with narrow, elongated toes, and shoes that could be worn over hosiery.

Similar to pattens, chopines were also platform shoes, but worn exclusively by women. Believed to have been created in 15th-century Turkey, chopines were adopted by the Venetians from the 15th to 18th century, and were popularly worn by courtesans and patricians.