The first century Jewish historian Josephus believed there was a connection between the twelve stones in Aaron's breastplate (as described in the Book of Exodus), the twelve months of the year, and the twelve signs of the zodiac. Translations and interpretations of the passage in Book of Exodus regarding the breastplate have varied widely, with Josephus himself giving two different lists for the twelve stones. George Kunz argues that Josephus saw the breastplate of the Second Temple, not the one described in Exodus. St. Jerome, referencing Josephus, said the Foundation Stones of the New Jerusalem (Revelation 21:19–20) would be appropriate for Christians to use.

In the eighth and ninth century, religious treatises associating a particular stone with an apostle were written, so that "their name would be inscribed on the Foundation Stones, and his virtue. The custom of wearing a single birthstone is only a few centuries old, though modern authorities differ on dates. Kunz places the custom in eighteenth century Poland, while the starts it in Germany in the 1560s.

Ancient traditional birthstones are society-based birthstones. The table above contains many stones, which are popular choices, often reflecting Polish tradition.

The Gregorian calendar has poems matching each month with its birthstone. These are traditional stones of English-speaking societies.