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 from the next; 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 the Conferences. The Council organizes workshops and liturgies that bring together Vincentians from all the Conferences for educational programs and/or spiritual enrichment.
Administrative staff from the Central Council serves on the committees of the board and oversee the staffed programs and other activities of the Society.
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.