Originally appointed by the Regional Council of Marche, since 1995 de facto and 2000 de jure, he is elected by popular vote every five years under universal suffrage: the candidate who receives a plurality of votes, is elected.

His office is connected to the Regional Council, which is elected contextually: a majority bonus hugely increases the number of his supporters in the assembly.

The popular election of the president and the relationship of confidence between him and the legislature, allow to identify the Lombard model of government as a particular form of semi-presidential system.

The president appoints and dismiss the Regional Cabinet (called Giunta Regionale in Italian).

The Cabinet is composed by no more than sixteen regional assessors (assessori, literally "aldermen"[1]) who can be members of the Council at the same time.