The ‘fluid mechanical sewing machine’ is a device in which a thin thread of viscous fluid falls onto a horizontal belt moving in its own plane, creating a rich variety of ‘stitch’ patterns depending on the fall height and the belt speed. This review article surveys the complex phenomenology of the patterns, their symmetries, and the mathematical models that have been used to understand them. The various patterns obey different symmetries that include (slightly imperfect) fore–aft symmetry relative to the direction of belt motion and invariance under reflection across a vertical plane containing the velocity vector of the belt, followed by a shift of one-half the wavelength. As the belt speed decreases, the first (Hopf) bifurcation is to a ‘meandering’ state whose frequency is equal to the frequency Ωc of steady coiling on a motionless surface. More complex patterns can be studied using direct numerical simulation via a novel ‘discrete viscous threads’ algorithm that yields the Fourier spectra of the longitudinal and transverse components of the motion of the contact point of the thread with the belt. The most intriguing case is the ‘alternating loops’ pattern, the spectra of which are dominated by the first five multiples of Ωc/3. A reduced (three-degrees-of-freedom) model succeeds in predicting the sequence of patterns observed as the belt speed decreases for relatively low fall heights for which inertia in the thread is negligible. Patterns that appear at greater fall heights seem to owe their existence to weakly nonlinear interaction between different ‘distributed pendulum’ modes of the quasi-vertical ‘tail’ of the thread.