The massage is carried out on the floor on a futon-type mat and is never rushed, usually taking around two hours. To receive it you need to wear loose, comfortable clothing so that movement is unrestricted. Occasionally oil or balm may be used on painful areas.

The therapist uses her hands, thumbs, elbows and feet to apply pressure along the lines and then uses her whole body to create stretches, lifts and twists. The rhythmic, flowing manner in which the massage is given encourages the release of tension. Thai yoga massage has even been described as dance-like and, in true Thai tradition, the massage is applied as a meditative practice given with metta or loving kindness.

For those who have severe back problems and are unable to comfortably lie on their backs, an entire massage can be given with the recipient lying on their side.