The Inaugural Meeting of the Boards of Governors was held in Savannah, Georgia, USA in March 1946. The first Annual Meetings were held in Washington in 1946.

In recent years, the Annual Meetings have been preceded by meetings of the International Monetary and Financial Committee, the Development Committee, the Group of Ten, the Group of Twenty-Four, and various other groups of members. At the conclusion of their meetings, the International Monetary and Financial Committee and the Development Committee, as well as several other groups, issue communiqués. The Annual Meetings include 2 days of plenary sessions, during which Governors take up matters of business, consult with one another, and address the assembled delegates to present their countries' views on current issues in international economics and finance. At the Annual Meetings, the Boards of Governors make decisions on how current international monetary issues should be addressed and approve corresponding resolutions. The Annual Meetings are chaired by a Governor of the Bank and the Fund, with the chairmanship rotating among the membership each year. Every two years it elects Executive Directors. Each year any new members are welcomed into the Bank and Fund.

Because the Annual Meetings bring such a large number of member country officials together, they provide opportunities for consultations large and small, formal and informal. Numerous seminars are held in conjunction with the meetings, including seminars conducted by staff members for members of the press. The Annual Meetings Program of Seminars is designed to foster creative dialogue among the private sector, government delegates and senior Bank and Fund officials. The Per Jacobsson Lecture on international finance, which is sponsored by a foundation set up in honor of the Fund's third Managing Director, is also given each year in conjunction with the Meetings.