Originally appointed by the Regional Council of Tuscany, 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.

The Council and the president are linked by an alleged relationship of confidence: if the president resigns or he is dismissed by the Council, a snap election is called for both the legislative and the executive offices, because in no case the two bodies can be chosen separately.

The popular election of the president and the relationship of confidence between him and the legislature, allow to identify the Tuscan 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 eight regional assessors (assessori, literally "aldermen"[1]) who cannot be members of the Council at the same time.