The area consists of two cities and numerous towns: to the east, the city of Birmingham, along with adjacent towns of Solihull and Sutton Coldfield; and to the west, the city of Wolverhampton and the area called the Black Country, containing the towns of Dudley, Walsall, West Bromwich, Oldbury, Willenhall, Bilston, Darlaston, Tipton, Smethwick, Wednesbury, Rowley Regis, Stourbridge and Halesowen.

Occasionally the conurbation is seen as being coterminous with the West Midlands Metropolitan county; however, this includes Coventry, which is separate from the main urban area, and excludes the parts of the surrounding counties of Staffordshire, Warwickshire and Worcestershire that fall within the conurbation.

For administrative purposes, the vast majority of the conurbation falls within the six Metropolitan Boroughs of Birmingham, Dudley, Sandwell, Solihull, Walsall and Wolverhampton.

Two Local enterprise partnerships (LEPs) cover the majority of the conurbation area: Black Country LEP comprises the local authorities of Dudley, Sandwell, Walsall and Wolverhampton while the Greater Birmingham & Solihull LEP includes those two authorities and a number of satellite boroughs, many remote from the conurbation and not traditionally associated with it (Bromsgrove, Cannock Chase, East Staffordshire, Lichfield, Redditch, Tamworth and Wyre Forest).

In the 2011 Census, Coleshill and Water Orton are two separate built-up areas with populations of 6,341 and 3,444 respectively.