The order, which includes three grades (Grand Officer, Officer and Knight) is conferred upon men and women, either Canadian citizens or foreigners who are either residents of Québec or were born there, "for outstanding achievements in most fields." The law also grants the premier of Québec the exclusive privilege of nominating foreigners. Foreigners inducted into the order are often honoured for a loyal friendship to Québec, helping make Québec better known and respected on the international stage, or for defending the French language.

The Council of the National Order of Québec (Conseil de l'Ordre national du Québec), elected by and amongst the members of the order, has the mandate of publishing favourable notices of advice based on nominations received after public calls published in Québec newspapers. The notices of the council are given to the premier, who submits them to the Council of Ministers for the final decision.

The insignia are delivered during ceremonies at the Salon Rouge in the Parliament Building, which was the former home of the Legislative Council of Québec. Exceptions are made when inductees cannot be present (notably for some foreign nominations).