There has been limited research into the impact of some aspects of voting procedure but very little research into ballot paper design and the act of voting in itself. This article gives a historical overview of the evolution of voting procedures from ancient times to the modern day, describes the results of a survey of 134 paper ballots used over the last decade for national legislative, executive and referenda elections in 107 countries, and gives the findings of a laboratory experiment testing the impact of ballot paper design. The evidence suggests three things: first, elaborate ballots (incorporating colors, symbols and photographs) are more likely to be found where literacy is lower and competitive multi party elections are a new phenomenon. But elaborate ballots are not significantly related to the level of democracy, the effective number of parties, or the type of electoral system. Second, there is little evidence to suggest that elaborate and costly ballots reduce spoilt ballot rates or are essential tools for illiterate voters. Rather, the negative correlation between ballot design and spoilt ballots, combined with the weight of historical evidence which shows that ballots are often a highly manipulative tools of political symbolism, implies that ballot papers symbols, photographs, layout, and color are of most interest as political cues (for both literate and illiterate voters). This intuition is confirmed by the results of a vote simulation experiment conducted on 401 students in which ballot design had a pronounced effect on voting behavior.