The colorful dresses worn by Choctaw women are made by hand and probably adapted from a 19th century dress design. No pattern exists for the dresses, which consist of a bodice with fitted waist and a long, full skirt trimmed with ruffles and hand-sewn applique. The dressmaker simply takes a series of measurements from the person who will wear the dress and cuts out the shapes that will make up each part of the dress. A white apron, trimmed in the color of the dress, completes the woman's taditional outfit. Men's shirt, designed with either a round neckline or an open collar and applique work on the front and sleeves, are made in much the same way.

Choctaw dresses are usually trimmed with one of three motifs: full diamond, half diamond, or a series of circles and crosses that represent stickball and stickball sticks. The diamond design, which is often seen on Choctaw basket as well, represents the eastern diamondback rattlesnake. Occasionally, images borrowed from other tribes, such as the thunderbird, are used.

A few older women still prefer Choctaw dresses for everyday wear. These dresses are made from a print fabric and are shorter than the dresses worn for dancing. Instead of time-consuming hand applique, these dresses are usually trimmed with rick rack. The apron is worn with these dresses as well.

Most Choctaws today wear Choctaw dresses and shirt mainly for social dances or other special occasions. They are made from cotton fabric, in solid colors with a contrasting trim. Occasionally, women choose silk or velvet fabric for traditional dresses, usually for events such as the Choctaw Indian Princess pageant.

Men and women alike often wear decorative beadwork with traditional clothing. Sashes are the most traditionally Choctaw accessory, feauring both beadwork and applique.

Many women wear round combs as with their Choctaw dresses. Old drawings suggest that originally these combs were made from silver or other metal. During the difficulty years after removal, Choctaws made round combs from men's celluloid shirt collars. Today they are made from plastic pieces cut from bleach bottles and attached to a purchased comb.

Handmade dolls provide examples of traditional clothing and beadwork. Many of the women who make dolls have developed their own patterns, while other adapt commercial doll patterns.