ACBL is the parent organization whose territory includes the United States, Canada, Mexico, and Bermuda. The members of ACBL are the base of the organization. Every ACBL member belongs to a unit, which is usually a defined geographical area. All units belong to one of the current 25 districts. These 25 districts encompass the geographic area of ACBL.

Units run sectional tournaments, and higher rated tournaments when given the right to do so by their district. Districts run regional tournaments and assist with NABC tournaments held within their region. The district may ask a member unit to run a regional tournament and/or assist with an NABC.

There are other entities (called clubs) which run ACBL-sanctioned bridge games. See Chapter 4. Two major types of duplicate bridge sanctions are issued by ACBL: those issued annually for regularly scheduled masterpoint games at clubs, club championships, charity game championships, and membership tournaments; and those issued individually, as requested by ACBL affiliated districts and units.

Among the latter are: all unit-wide, district-wide, and ACBL-wide games; unit championships and charity events; sectional and regional championships; North American bridge championships; and special events such as team playoffs, pair trials, and international events. ACBL sanctions and promotes all of these games.