First Presbyterian Church, like all Presbyterian churches, has a representative and constitutional form of government. The church is governed by officers elected by the congregation. Their authority is defined and limited by the Constitution of the Presbyterian Church (U.S.A.), to which First Presbyterian Church adheres.

The church’s council is the Session, which has both clergy and lay members (teaching elders and ruling elders). The Session is assisted in its work by deacons, who are organized into a separate body known as the Diaconate. The Diaconate is supervised by the Session. The Session in turn is answerable to the other PCUSA governing bodies of which it is a part. These are, in ascending order, the Presbytery of Middle Tennessee, the Synod of Living Waters, and the PCUSA General Assembly.

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