In its current format, the Eastern Intermediate Hurling Championship begins with a group stage.

On 31 January 2022, Waterford County Board delegates voted on the restructuring of the entire intermediate hurling championship system following a review process.

The teams are ranked in the group stage table by points gained, then scoring difference and then their head-to-head record.

The fifth and sixth-placed teams from the group stage take part in a relegation playoff to determine who drops to the Eastern Junior A Hurling Championship.

[3] This format was abandoned for a period in the late 1970s and early 1980s when a county-wide Waterford IHC was in operation, however, it was later reinstated.