- The cotton shirt design is transferred to a pattern. From the pattern, the cotton cloth is cut with shears. The cut-outs result in a tubed section (or front and back sections, depending on the designer's specifications), trim and sleeves (some patterns include pockets).
- Front and back sections are stitched together along the sides of the shirt cloth (unnecessary for tube body patterns). The stitching is done with an overedge stitch. The sides are lined at the seam, then stitched. The sleeves are hemmed before being sewn onto the tube section of the shirt. The hem is created by folding the edge and stitching. If the shirt is not tubed and is two separate cloth bodies, then the sleeves are left unseamed. The sleeves in this case are sewn directly onto the body, and later sewn with the side seams together. A hem is sewn into the garment with an overedge stitch machine (an industrial machine for a triple thread stitch job).
- The shoulder seams are sewn onto tube body shirts before the neckband is applied. Shirts made from two pieces of cloth have the neckband sewn onto the shirt before closing the shoulder seams. Neckbands vary in style. The neckband on a crew neck shirt is wide on the edge that is sewn into the cotton shirt, with the neck hole being less wide in circumference than the part that is sewn onto the shirt. The neckband on a tube body shirt is made by folding the bands with the sides stretched and aligned to the neckline. The seam is then stitched with an overedge machine. The seams on some cotton shirts are left visible by attaching the neckbands on the front and back of the necklines separately (with the shoulder seams being stitched last). A bound seam is even more quickly accomplished by inserting ribbed fabric in to a fabric folding machine, which then applies pressure to the ends of the bound seam. The fabric is then sewn onto the neck of the cotton shirt.
- Pockets are added on to casual cotton shirts. An interlining is sewn inside of the pocket to keep its shape. The pocket is either hand sewn onto the cotton shirt, or it is sewn with a pocket setter sewing machine (the latter is programmed to automatically set the pocket on to the shirt, and then sew the pocket into the fabric).
