Baptized members are organized into congregations. The elected head of the congregation is a president or chairperson who also presides at congregational council. ELCIC congregations use a variety of organizational patterns. They develop their structures to fit their local needs.

Congregations belong to a synod. There are five of these in the ELCIC. The Eastern Synod, Manitoba/Northwestern Ontario Synod, Saskatchewan Synod, Synod of Alberta and the Territories, and the British Columbia Synod. A bishop is the elected head of each synod.