The Presbytery of Hamilton is part of the Church of Scotland which can trace its origins to the beginnings of Scottish Christianity in 395AD when St Ninian first established a Church. A Presbytery is the characteristic and fundamental court of the Church of Scotland since it not only directly supervises ministers and Kirk Sessions, but also elects those who form the General Assembly. The General Assembly is the highest court of the Church of Scotland and it determines operational matters for all congregations within presbyteries.

The Presbytery consists of the ministers and representative elders, from each of the congregations in its area, who have responsibility for church activity within their own boundaries. There are also elders, called additional elders, chosen by Presbytery to make sure that retired and specialist ministers entitled to membership of the Court do not cause ministers to outnumber the elders in its members. Representative elders are elected annually by their own Kirk Session.

The principal office-bearers are the Moderator, who is elected annually, the Clerk and the Depute Clerk.

The Presbytery supervises the ministers, kirk sessions and congregations in its area, and elects local ministers and elders who will attend the annual General Assembly of the Church of Scotland.

Presbytery meets throughout the year, normally monthly, except for January, April, July and August. The Presbytery meeting in October is of a conference style and focuses on topical issues of interest. The work of Presbytery is carried out through its committees; proposals for decisions are brought in the name of the relevant committee to meetings of Presbytery.

Amongst other things, the responsibilities of Presbytery include setting parish boundaries, determining how many congregations there may be within its bounds and the allocation of ministers and other parish staffing among them and dealing with services for ministers coming to or departing from its bounds. It has supervisory responsibilities for congregations, ministers and also for students who are in training for the ministry. Both as a court and through its committees, it deals with a wide range of issues including education, social work, church property, inter-church relations and the Church's ministry and mission within the bounds.

Presbytery is the court of appeal for all matters which are dealt with by Kirk Sessions, as well as having the power to review decisions made at congregational meetings. Presbytery conducts a review of every congregation within its bounds, normally once every five years. This gives counsel and encouragement to the congregation, facilitates the congregation in setting out priorities and plans and, where anything is considered unsatisfactory, gives advice or takes supportive or remedial action.

In addition to appointing General Assembly commissioners, Presbyteries have potential changes to Church legislation sent down to them by the General Assembly for consideration under the Barrier Act. This Act, which dates from 1697, is designed to prevent sudden major changes in the most important areas of the Church's life. It requires that at least half the presbyteries must approve the proposed new legislation before it can be brought to the next General Assembly to be passed as an Act.