When you hear the term "annual conference," it could be referring to any one of three things. The annual conference is a regional body, an organizational unit AND a yearly meeting.
The annual (sometimes referred to as 'regional') conference is described by the church's Book of Discipline as the "basic unit" of the church.
An annual conference may cover an entire state, only part of the state, or even parts of two or more states. There are also three missionary conferences in the United States, which rely upon the denomination as a whole for funding.
The United States has 57 annual conferences, supervised by 46 bishops. There are 76 annual conferences in Africa, Europe, and the Philippines, which are supervised by 20 bishops.
The annual conference has a central office and professional staff that coordinate and conduct ministry and the business of the conference. It likely has a director of connectional ministries, treasurer, directors of program areas (such as camping), communications director, and other staff as deemed appropriate for the annual conference and as required by the Book of Discipline. Clergy and laypersons may also serve on conference boards, commissions and committees.
Annual Conference sessions
Each year — usually in May or June — all clergy members and an equal number of lay members selected from the local churches attend their conference's Annual Conference sessionmeet together to worship, fellowship, and conduct the business of the conference, which may last 3-5 days. During these sessions, members of the conference hear reports of past and ongoing work; adopt future goals, programs and budgets; ordain clergy members as deacons and elders; and elect delegates to Jurisdictional and General Conferences (every 4 years). The bishop presides over these meetings.