The Fellowship serves in the Middle East, North Africa and, more recently, Indonesia, Pakistan, Nigeria, Somalia, Tanzania and Kenya on behalf of Reformed Churches and believers worldwide.
The General Director is the Reverend Victor Atallah, based in Larnaca, from where he travels extensively promoting and encouraging the work of the Fellowship.
The Bible and the historic reformed confessions form the theological basis for the Fellowship, which aims to "declare the whole counsel of God".
Gospel radio programming in local languages is broadcast from Radio Monte Carlo through transmitters located in Cyprus and Monaco, in conjunction with Words of Hope, a ministry of the Reformed Church of America, and The Back to God Hour, a ministry of the Christian Reformed Church in North America.
According to Allan M. Harman, MERF has "done much to propagate the gospel in Arabic, to bring leaders out of their home countries for periods of training and to administer fine diaconal projects that have alleviated the pressing needs of many in Muslim communities.