The practice involves cutting a girl's vagina to create a seal that narrows the opening, making it just wide enough to allow the passing of urine and menstrual blood. Infibulated girls often have their legs bound together for up to four weeks to allow the freshly fused tissue to heal.

In most cases cutting is done by a traditional practitioner without any anesthesia and little care for hygiene. Razors, knives, or scissors are used and they are rarely sterilized. The surgery takes place wherever it is convenient, from out in the open to a bathroom floor.