Generally, an administrative hearing is held when a law requires that a government agency conduct a hearing prior to taking an action that affects legally protected rights. An administrative law judge presides over the hearing and serves as the trier of fact.

Most OATH cases are offered a pre-trial conference before going to trial. At the conference, an administrative law judge other than the trial judge meets with the parties and their representatives to see whether the case can be settled amicably, without the need for a trial.

Most trials at OATH are open to the public. The parties are entitled to be represented by attorneys, although OATH's rules also permit non-lawyers and self represented parties to appear. OATH trials generally follow the traditional trial sequence: opening statements, each party's direct case with cross-examination by the other party, and closing arguments. In most cases, the burden of proof is on the petitioner, who must prove the case by a preponderance of the evidence, which is the same standard applied in civil court proceedings. OATH's procedures relax the technical rules of evidence that would apply in court proceedings. All OATH trials are digitally recorded and, in some cases, transcripts are prepared for use by the administrative law judges in making their decisions.

Many cases are referred to OATH for recommended decisions, and the head of the agency that referred the case makes the final decision. Other cases are referred to OATH for final decisions by an OATH judge.

All OATH proceedings are governed by rules of practice published in title 48 of the Rules of the City of New York (RCNY).