The Society is structured in a way that regional Councils (usually paid staff), supports local Conferences (volunteer groups) in their efforts to serve the needy in their local communities. Each Council operates autonomously; however, all are bound by the rules of the National Council in St. Louis, where the first U.S Council was formed in 1845. Additionally, each Council sets the rules and regulations for its Conferences based on the philanthropic environment in their local region. Although each Council operates differently, the mission and services remain central to growing spiritually through service to the poor.
The Central Council headquartered in Bethpage serves as a resource center, providing support services, financial aid, and technical assistance to its Conferences. The Council organizes workshops and liturgies that bring together Vincentians from all the Conferences for educational purposes and spiritual enrichment.
The Executive Director and Program Directors belong to a number of community-based organizations whose missions coincide with the Society's. These affiliations promote cost sharing, expand the Vincentian’s access to services, and increase the effectiveness of advocacy efforts on behalf of the poor.