The league includes teams from countries such as Bulgaria, North Macedonia, Montenegro, Kosovo, Cyprus, and Israel.

The league achieves this by providing financial support to all participating clubs to offset the costs associated with international competition.

The tournament is divided into two phases: the regular season, where all participating teams play each other in a double round-robin format, both home and away.

The winning teams from these matchups then advance to the Final Four to compete for that season's BIBL Balkan League championship.

[2] Additionally, at the start of the 2020–2021 season, 12 teams from Israel participated in the league to ensure access to competitive games during the COVID-19 pandemic.