The meeting place is a tipi with its entrance to the east. A crescent-shaped altar and fire are prepared according to custom. A drum, feather fan, eagle humerus whistle, gourd rattle, Bull Durham tobacco, and sagebrush complete the necessary ritual equipment. The chief or leader usually supplies the peyote for the meeting. Members bathe before the meeting, and about nightfall they gather in small groups outside the tipi—first the chief, then the chief-drummer, the cedarman, next the men, then the women and children with the fire-chief last—all making their way into the tipi.

The leader places the "chief peyote" upon some sagebrush leaves on the top of the altar and prays. Everyone is invited to speak of their ills and struggles, so that prayers may be voiced in their behalf. The Bull Durham tobacco is passed and cigarettes are made and lit from the glowing firestick. Each person blows the first four puffs of smoke toward the "chief peyote" on the altar and prays. The cigarette butts are then placed at the base of the altar.

Next, sprigs of sagebrush are passed and the leaves are rubbed between the hands, sniffed rubbed over the limbs, and beaten four times against the chest to purify the body. A sack of peyote follows the sage, and each adult takes four buttons. Since the peyote is extremely bitter and nauseous, coughing and spitting often succeed the arduous swallowing. Everyone sits as still as possible until all have finished eating the medicine, because the partaking of the divine plant during meetings is a sacred procedure and supposed to be accompanied by silent prayer.

After the eating, the chief holds the staff and fan, shakes the rattle, and sings the Opening Song, accompanied by the chief-drummer's rapid drum beats. Only four songs have to be sung at fixed times: the Opening Song, the Midnight Water Call, the Morning Water Call, and the Closing Song. During the remainder of the ritual each man sings any song he wishes when it is his turn to lead, holding the staff and fan in one hand and shaking the rattle with the other. Women neither hold the staff to lead the singing nor beat the drum.

With midnight and the Midnight Water Call, the fire-chief replenishes the fire, the Midnight Song is sung, and prayers are offered through four puffs of smoke. All drink water. Singing then continues with renewed vigor each using their own equipment. Personal supplies of peyote may be consumed after midnight, and prayers continue to be offered.

A special morning ritual duplicates some features of the Midnight Water Call; the fire is refueled and the central altar area cleaned. The chief then sings the Morning Water Call, and following the four blasts on the whistle, a woman, usually the chiefs wife, brings in the water and kneels. After ceremonial duties, the water is again spilled on the ground, a breakfast follows, and the Closing Song is sung, followed by more lengthy prayers and blessings. All equipment is dismantled and put away, and then the fire-chief leads the exit, followed by the chief. Once the ritual is over, the women leave to prepare the noon feast and the men to rest, relating their spiritual experiences and visions.