With the rise of towns and the establishment of a money economy in western Europe, the fabrication of rings grew into an urban trade. In 1180, the Goldsmith's Company was founded in London, and in 1200, Jean de Garlande describes the craftsmen setting jewels into rings on the Grand Pont in Paris. Certain new types of rings evolved and were commercially made in large numbers for all levels of society. In France in 1283, then in London in 1337, 1363, and 1463, and elsewhere, sumptuary laws were passed forbidding townspeople from wearing precious stones, but it is unlikely these regulations were strictly observed.

Medieval rings are typically set with uncut but polished stones (called cabochons) because the stone itself was considered God's creation, not to be altered artificially by man. For the same reason, there was a taboo about the mixing of colors in the workshops of painters and their assistants. Two types of rings abound in the Gothic era. The first is the stirrup ring, made in the shape of a horse's stirrup and nearly always set with a cabochon sapphire. Many of these have been discovered in the tombs of the bishops for whom they were made. The second is the tart mold ring, adorned with different precious stones in a box or circular setting the underside of which resembles a pie plate. Other types of rings also proliferate: for example, nominative rings with circular inscriptions used for sealing, black letter rings with amatory sayings on the bands, iconographic rings with standing figures of saints that served to protect the wearer, etc. Claw and box settings both occur in Gothic rings, but eventually the claw setting naturally evolves into the most popular late Gothic type of gemstone ring, the cusped ring, in which the collet consists of decorated lobes between the remnants of claws. It is this type of ring that continues into the early Renaissance and occurs in Gerard David's painting.

An art history of medieval rings has yet to be written (see, however, Hindman et al., 2007), but a few preliminary observations can nevertheless be made. The streamlined form of the stirrup ring, arching upward to the bezel that forms an integral part of it, recalls the aesthetic of the unification of the wall in Gothic cathedrals with the ribs springing seamlessly to the arched vaults. Tart mould rings take inspiration from the architectonic forms of capitals and their bases. The ridged bezel of the iconographic ring adorned with standing saints in niello reiterates in miniature format the closed wings of a painted altarpiece, its figures painted in grisaille. Iconographic rings, as well as other devotional types of rings, find their parallels in the suffrages, or prayers of protection to special saints that accompany Books of Hours.