The Council meets annually to establish policy. The Council Steering Committee (CSC) oversees the activities of the council. Together with the CSC, the Council facilitates communication with state chapters and with the BOC.
Each state chapter has one councilor for every 100 ACR members in the chapter. Additionally, CARROS has one councilor, five councilors are allotted to the Resident and Fellow Section, and two councilors are allotted to the Young and Early Career Professional Section. In addition, the military services, other federal agencies and 23 radiological societies are represented by councilors.
In order to organize the council meeting and to maintain activities throughout the year, the Council elects a speaker and vice speaker who serve two-year terms.