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The term Final Four refers to the last four teams remaining the playoff tournament. These are the champions of the tournament's four regional brackets, and the only teams remaining on the tournament's final weekend. (The term has been applied retroactively to include the last four teams in tournaments from earlier years, when only two brackets existed.)

Some claim that the phrase Final Four was first used to describe the final games of Indiana's annual high school basketball tournament. But the NCAA, which has a trademark on the term, says Final Four was originated by a Cleveland Plain Dealer sportswriter, Ed Chay, in a 1975 article that appeared in the Official Collegiate Basketball Guide. The article stated that Marquette University “was one of the final four” in the 1974 tournament. The NCAA started capitalizing the term in 1978.

Currently, the men's tournament begins with 65 teams. The two teams deemed weakest by the NCAA Selection Committee play the first game (the "play-in game") in Dayton, Ohio, and the field is narrowed down to 64 teams. The women's tournament starts with 64 teams, with no play-in game. The tournament proceeds by means of single elimination play on consecutive weekends in March at preselected sites in the United States.

In the men's tournament, all sites are nominally neutral: teams are prohibited from playing tournament games on their home courts (though in some cases, a team may be fortunate enough to play in or near its home state or city). Under current NCAA rules, any court on which a team hosts more than three regular-season games is considered a "home court" (conference tournament games are not counted for this purpose). In the 2006 tournament, Villanova was able to play its first two games at the Wachovia Center in nearby Philadelphia, a venue where it had played three regular-season home games. A fourth home game at that facility would have disqualified them from playing there. However, some semi-"home" courts (such as George Mason playing its regional at the Verizon Center in Washington, D.C., not far from its campus in Fairfax, Virginia, in 2006) are mere quirks of scheduling and have been part of the tournament for years.

On the third weekend, traditionally a Saturday and Monday for the men's tournament and a Sunday and Tuesday for the women's tournament, the final four teams meet in semifinals on the first day and the championship on the second. For several years in the men's tournament, the teams eliminated in the semifinals met in a consolation game prior to the championship; this was discontinued in 1981.

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