Accomack County is governed by the Board of Supervisors as required by the Code of Virginia. The Accomack County Board of Supervisors consists of nine representatives and each represent one of the County's nine election districts. Supervisors are elected for four year terms and the election is held during the November general election.

The first Board meeting of the year is an organizational meeting. During this meeting the Board elects one of its members to serve as chair and another to serve as vice chair. The chair presides at each Board meeting and serves as the official head of the County government. The vice chair serves in the absence of the chair. The Board also sets the date, place, and time for the regular monthly meetings and work sessions. The Accomack County Board of Supervisors Code of Ethics and Rules of Procedures are adopted during this meeting as well.