The Commission elects a chairman and vice-chairman annually, and adopts its own rules and procedures. The Commission has authority to:

• Adopt ordinances, emergency ordinances, and resolutions governing the operation of government or to regulate the conduct and affairs of the residents of Knox County.
• Create executive departments and divisions within the executive departments upon recommendation of the County Mayor.
• Establish special districts and provide for assessments and tax levies on real and personal property or privileges for the purpose of providing services not generally available to citizens countywide.
• Review and may alter the budget recommended by the County Mayor, adopt the budget, and set the county property tax rate.
• Approve the issuance of bonds or other indebtedness to finance county capital improvements projects.
• Approve subdivision roads that are built to standard, the sale of county property, and condemnation of property for public welfare.
• Consider and approve comprehensive general and specific plans and zoning ordinances, prepared by the Metropolitan Planning Commission, and building regulations.
• Adopt other ordinances and resolutions that promote the public welfare.