IT'S SAFE TO SAY women have never had such a complicated love/hate relationship with a gem or semiprecious stone as they've had with the pearl. While grande and fashionable dames as varied as Queen Elizabeth I and Jackie Kennedy adored theirs, modern women can find the look less than fresh.

"Nobody of our generation ever wanted to wear pearls because it was thought that you would instantly look old," said 48-year-old jewelry designer Marie-Hélène de Taillac. But the push-pull dynamic seemed to dramatically shift this season—with pearls showing up on everything from shoes to wallpaper to chairs.

The pearl got a moment to shine at the Alexander McQueen fall show in Paris where each of the 10 looks—worthy of Elizabeth I herself—glimmered from neckline to hemline with pearly beads. The luminous orbs covered punky knee-high leather boots, and dotted fishnet stockings and queenly, ruff-necked dresses. Pearls also snaked across the lattice masks worn by each model. One look featured 25,000 pearls.

That collection nudged pearls well beyond the prim and stuffy connotations of the classic two-strand necklace over a twin set. Ms. de Taillac set herself the same goal when designing a new collection for Japanese jewelry brand Tasaki. "The challenge was to make young girls want to wear pearls," she explained. She mixed them with her signature multicolored stones, fashioning, for instance, drop earrings that cap a single pearl with a delicate crown of rainbow gems. She also had a little fun with irreverently sweet necklace clasps: lips, stars and hearts made of brushed 22-karat gold.

"If you're going to do pearls, you really need an edge of some kind," said New York-based designer Lela Rose. Ms. Rose, who hails from Dallas, never wore them as a girl. With her blond hair and "Texas smile," she said, "I would have looked like such a dork." However, in her fall collection she embroidered them all over a silk-and-cashmere sweater like polka dots. "I think pearls are having a resurgence," she added, "but no one wants to wear them in an old way."

It's conceivable that Elizabeth I might have worn pearls on her shoes, but British designer Nicholas Kirkwood's pearl-trimmed pumps and sandals seemed like a new statement. "There's a sort of purity in the roundness of pearls," said Mr. Kirkwood. "I see it as a real modern gem, I guess."

Pearls, modern? Well, given that arch-modernist Raf Simons has been using them recently for various pieces of jewelry in his collections at Christian Dior, it almost seems foolish to argue otherwise.

One designer who has always loved the pearl's allure is jewelry maven Aurélie Bidermann, who created a group of new pearl designs for fall. As a teenager, she wore a strand passed down from her grandmère, balancing the inherent elegance of the jewels with typical gamin Parisian charm. "I was dressed very tomboy, in jeans and shirts," she said.

Ultimately, though the pearl's trendiness might wax and wane, it has a timeless appeal. "Pearls are never not flattering," said Verdura CEO Ward Landrigan. "They bring light to the face, which is what jewelry is for. It's not an intellectual thing. They're just beautiful."