The term "monthly" comes from the practice of holding a monthly Meeting for Business, separate from the Meeting for Worship held once a week on Sunday (often called "First Day" for reasons discussed in the Testimony of Simplicity.) Similarly "quarterly" refers to the fact that members of a quarterly meeting gather four times a year. In some areas, including Britain and Ireland, there are local (preparative) meetings, which fall under the care of the larger Monthly meetings.

A Monthly meeting is usually associated with a particular place of worship; in many cases, the associated meetinghouse has a distinctive style of architecture, reflecting the Testimony of Equality (benches are arranged in a roughly circular or three-quarter-square configuration, with no "privileged" place) and the Testimony of Simplicity (the interior of the meetinghouse is usually kept simply and unadorned.) Some meetinghouses in the United States are among the earliest remaining religious structures in the country, particularly in the Philadelphia area, but also in the Mid-Atlantic states and the Midwest generally.

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