Characteristics of Quad City–style pizza include malt in the crust, tomato sauce made with red chili flakes or cayenne pepper, toppings placed under the cheese, and being cut into strips instead of triangular slices.

[3][4][5] Quad City–style pizza dough contains a characteristic spice jam which is heavy on malt,[6] which lends it a toasted, nutty flavor.

[1] The pizzas are hand-tossed to be stretched into an even quarter-inch thin crust with a slight lip ringing the edge.

The sauce contains both red chili flakes and ground cayenne pepper, and the smooth, thin tomato spread is more spicy than sweet.

[10] The dish has been prepared in other areas of the United States, including Mahtomedi, Minnesota; Acworth, Georgia; Harrisburg, North Carolina; Mesa, Arizona;[11] West Des Moines, Iowa; Northwest and Central Indiana and Chicago, Illinois.