The regional assembly is the highest political body in the region and its members are elected by the population of Skåne Country, as opposed to the County Administrative Board (länsstyrelsen) which represents the interests of the state within the county, under the chairmanship of the county governor.
By devolution the newly formed region assumed some powers from the Skåne County Administrative Board, the state authority in Skåne County.
Before Region Skåne was formed in 1999 on a trial basis, the regional development was the responsibility of a Regional Association, comprising the 33 municipalities together with the then current health services principals, namely the Kristianstad and Malmöhus county councils and the Health Services authority in the City of Malmö.
The regional assembly (Swedish: regionfullmäktige, formerly landstingsfullmäktige) meets at Skåne Town Hall in Kristianstad.
The current chair of the executive committee is Carl Johan Sonesson of the Moderate Party, who succeeded Henrik Fritzon of the Social Democratic Party following the 2018 elections.