[6] After the mix is prepared, it is encased in banana leaves, synthetic sausage casings or tubular plastic bags and left to ferment for three to five days.

[4][5] Naem has a sour quality to it due to the fermentation, in which lactic acid bacteria and yeasts grow within the sausage.

[5] The lactic acid bacteria and yeasts expand by feeding upon the rice and sugar, and the use of salt prevents the meat from rotting.

[8] Naem is often consumed raw,[9] (after fermentation has occurred), and is often accompanied with shallot, ginger, bird's eye chili peppers and spring onions.

Luang Prabang som moo is very popular because of its unique texture and a tasty sour flavor.

[15] Naem and rice are formed into balls, deep-fried, and then served broken atop the various ingredients.

[16] Serenade, a restaurant in Bangkok, makes a dish called the "McNaem", which consists of a duck egg wrapped in naem that is fried and then served with risotto, slaw, shiitake mushrooms, herbs, and cooked sea scallops atop crushed garlic.

[19] According to the "Industrialization of Thai Nham" by Warawut Krusong of the King Mongkut's Institute of Technology Ladkrabang vitamins B1 and B2, ferric iron, and phosphorus were present in naem, quantities unspecified.

[7] Use of the starter culture Lactobacillus curvatus has been shown to prevent "the outgrowth of pathogenic bacteria" in naem.