It is a single-elimination tournament involving 8 of the 11 league schools, and seeding is based on regular-season records with head-to-head matchup as a tiebreaker.
The winner normally receives the conference's automatic bid to the NCAA women's basketball tournament.
An exception was in 2024, when Southern Indiana swept the conference's regular-season and tournament titles but was not eligible for the NCAA tournament because of its ongoing transition from NCAA Division II.
[1] For the 1978-79 season, a tournament was held to determine the champion of the conference, though it was not a postseason tournament due to it being held from February 8–10, with the season running until March 9.
Southeast Missouri vacated the 2005-06 title due to NCAA penalties.