Genkō yōshi may be used with any type of writing instrument (pencil, pen or ink brush), and with or without a shitajiki (protective "under-sheet").
Primary and secondary students in particular are required to hand in assignments written on genkō yōshi, and essays for school entrance examinations are also written on the paper, making knowledge of the correct way to use genkō yōshi essential.
In the centre of each two-page spread of genkō yōshi (between the two sets of ten columns) is a wide blank space, allowing the sheets to be bound or folded.
Prior to the Edo period, handwriting was often calligraphic and written materials often made use of scrolls, which would have made the guidelines printed on genkō yōshi a hindrance, although paper was sometimes printed with vertical lines designed to keep columns of vertical writing straight.
Genkō yōshi came into common use in the middle of the Meiji period with the rising importance of newspapers and magazines, and the attendant need to count characters precisely.
Like printed vertical Japanese, full stops, commas, and small kana are placed in the top right corner of their own square.