The Commission's regular meetings are on the first Tuesday of each month at 9:05 a.m. and each third Tuesday of the month at 9 a.m. in the Clark County Commission Chambers, 500 S. Grand Central Parkway, Las Vegas. The Commission meets as the Zoning Board on the following Wednesday at 9 a.m.

The responsibility for this multi-faceted service delivery organization is borne by the seven-member County Commission, elected from geographic districts on a partisan basis for staggered four-year terms. County commissioners biennially elect a chairperson who serves as the Commission's presiding officer. The Commission, in turn, hires a county manager who is responsible for the administrative operations of County government.

Clark County commissioners serve as "ex-officio" as the governing bodies of the Las Vegas Valley Water District, Clark County Water Reclamation District, University Medical Center of Southern Nevada, Big Bend and Kyle Canyon Water Districts, and the Clark County Liquor and Gaming Licensing Board.