The medieval Arabs used the distillation process extensively, and there is evidence that they distilled alcohol. Al-Kindi unambiguously described the distillation of wine in the 9th century. The process later spread to Italy, where later evidence of the distillation of alcohol comes from the School of Salerno in southern Italy during the 12th century.

In China, archaeological evidence indicates that the true distillation of alcohol began during the 12th century Jin or Southern Songdynasties. A still has been found at an archaeological site in Qinglong, Hebei, dating to the 12th century. In India, the true distillation of alcohol was introduced from the Middle East, and was in wide use in the Delhi Sultanate by the 14th century.

Fractional distillation was developed by Taddeo Alderotti in the 13th century. The production method was written in code, suggesting that it was being kept secret.

In 1437, "burned water" (brandy) was mentioned in the records of the County of Katzenelnbogen in Germany. It was served in a tall, narrow glass called a Goderulffe.

Claims upon the origin of specific beverages are controversial, often invoking national pride, but they are plausible after the 12th century AD, when Irish whiskey and German brandy became available. These spirits would have had a much lower alcohol content(about 40% ABV) than the alchemists' pure distillations, and they were likely first thought of as medicinal elixirs. Liquor consumption rose dramatically in Europe in and after the mid-14th century, when distilled liquors were commonly used as remedies for the Black Death. Around 1400, methods to distill spirits from wheat, barley, and rye beers, a cheaper option than grapes, were discovered. Thus began the "national" drinks of Europe: jenever (Belgium and the Netherlands), gin (England), Schnaps (Germany), grappa (Italy), borovička (Slovakia), horilka (Ukraine), akvavit/snaps (Scandinavia), vodka (Poland and Russia), ouzo (Greece), rakia (the Balkans), and poitín (Ireland). The actual names emerged only in the 16th century, but the drinks were well known prior to then.