[9] A 1949 article in the Wheeling News Register described their pizza as "an Italian bread dough base garnished with a sauce of tomatoes, parsley and green peppers that's seasoned with oregano, served with anchovies, cheese, pepperoni or mushrooms.

[7][15][16] Ohio Valley pizza is characterized by a square crust topped with a savory[17][18] or sweet sauce and baked in a rectangular sheet pan[6] at around 550 degrees Fahrenheit.

[7] It is removed halfway through baking and topped with additional sauce and small amounts of cheese.

[10] The cooked pizza is then topped with cold ingredients including shredded Provolone cheese and often pepperoni or banana peppers.

[11] Some restaurants allow customers to purchase additional shredded cheese in a bag to sprinkle on top of their pizza.