The builders were probably influenced by pre-existing tomb-shrines. Whether those people had grown up locally, or moved into the Medway area from elsewhere, is not known. Based on a stylistic analysis of their architectural designs, the archaeologist Stuart Piggott thought that the plan behind the Medway Megaliths had originated in the area around the Low Countries; conversely, Glyn Daniel thought their design derived from Scandinavia, John H. Evans thought Germany, and Ronald F. Jessup suggested an influence from the Cotswold-Severn group. Ashbee noted that their close clustering in the same area was reminiscent of the megalithic tomb-shrine traditions of continental Northern Europe, and emphasised that the megaliths were a regional manifestation of a tradition widespread across Early Neolithic Europe. He nevertheless stressed that a precise place of origin was "impossible to indicate" with the available evidence.
