"Hanging" is defined by the Oxford English Dictionary as "specifically to put to death by suspension by the neck", and the practice is thought to have become a common form of execution during medieval times. In its original form the condemned was merely suspended by the neck with a rope to cause death by strangulation, which is often a slow painful death. The method of using a short stool or cart to have a condemned to stand on still causes strangulation in most cases.

Circa 1866, a long drop distance of 4 to 6 feet was considered a sufficient distance to break the neck of a person being hanged by Irish scientific writer Samuel Haughton. This was primarily employed as a more humane, quicker method of execution.

The neck-breaking ability is not specific to the noose, it is merely the most effective knot for such, as it can bear significant weight and also tighten quickly from tension. The shock to the spinal column from the drop distance causes near instant death.

Gallows were originally just scaffolds used to suspend a person before judicial execution by hanging, drawing and quartering them. These were easily modified for the physical drop used in contemporary hanging procedure.

The practice of hanging may have become popular because it is less messy than beheading or quartering, easy enough that a couple farmhands or other small group could perform it from a tree branch (lynching), and rope was cheap and easily accessible in almost any community.