The late medieval period, beginning with the advent of the black plague in the mid-14th century, saw the rise of widespread fascination with death, notably manifest in the arts. Authors such as Johannes von Tepl in Germany wrote dialogues between the ploughman and death about god and the justice of dying, while Decameron of the Italian Boccaccio is set against the background of a group trying to escape the disease of the city.

Attitudes towards the omnipresent death varied, but in general he was seen as the great leveller of social inequality, the final messenger of god, and the hand of fortune. Images of the hooded death with Scythe arose as well, as the reaper of the divine harvest, whose swing gathered all to their final reward.

The Danse Macabre, the Totentanz, was an artistic and dramatic response. Originating perhaps in the final convulsions of the dying, the souls were seen to rise from their graves, guided by the skeletal hand of death, and dance in the deep of night across the hills and forests, on their way to their final reward; this procession was re-enacted in plays, woodcuts, as well as stained glass in cathedrals.

The imagery tended to die down and resurface in times of plague. Later, the concept was brought to the fore again in the 19th century by poets such as Baudelaire andGoethe:

The watcher looks down in the deep of the night
On the graves of the dead from his tower;
The moon shines down on the churchyard, bright
with the glow of the heavenly power.
A lone grave stirs, and a second one then,
They rise from their rest, both woman and man,
In ghostly pale fetters and tatters.

-Totentanz, Johann Wolfgang von Goethe

There is a great scene playing on this theme at the ending of Ingmar Bergman's The Seventh Seal.