The members are elected via three provincial board districts, coextensive with the legislative districts of Negros Oriental, each sending three members to the provincial board; the electorate votes for three members, with the three candidates with the highest number of votes being elected.

As ex officio presiding officer, he only votes to break ties.

An additional three ex officio members are the presidents of the provincial chapters of the Association of Barangay Captains, the Councilors' League, the Sangguniang Kabataan provincial president; the municipal and city (if applicable) presidents of the Association of Barangay Captains, Councilor's League and Sangguniang Kabataan, shall elect amongst themselves their provincial presidents which shall be their representatives at the board.

*appointed on October 11, 2023[3] to replace Jaime L. Reyes who became Vice-Governor last May 31, 2023.

*appointed on June 13, 2023[4] to replace Manuel "Chaco" Sagarbarria who became Vice-Governor and eventually, Governor last May 31, 2023.