As most fantasy worlds, Sanctuary consists of cultures that shares different social traits. For now, the only thing that is known about these is that there is a mutual understanding of languages between the continents, and whether this is due to the fact that people speak multiple languages through their culture, of if there is a "common" language (English) that everyone shares is unknown. Players as well as [[character]]s and [[NPC]]s in the world travel to either side of the globe, and can still communicate with people.

Names are more socially inspired though, and country does show there must be some diversity with languages in the lands. Country names such as "[[Westmarch]]", and town names such as "[[Tristram]]", has a clear "Western" reference from ''our world'', as does the architecture. [[Deckard Cain]] is a character name from a person of the west, while "[[Abd al-Hazir]]" is the name of a character from the flourishing East. If everyone shares a "common" language, they still seem to retain their own cultural names.