The meat used is thinly sliced rib-eye or top round although other types are often used.[6] The steak is placed on a lightly oiled griddle at medium temperature. The slices are quickly browned and then scrambled into smaller pieces with a flat spatula. Often, the steak is placed on top of already slightly fried onions to prevent the steak from becoming over-cooked. Thicker slices are also sometimes used (as are chunks of frozen thin slices which are defrosted as they are cooked). Some vendors omit the chopping, serving their sandwiches with these slices of steak in whole form.

Some locations with large volumes will griddle the steak in a large pile, chopping and flipping the steak with a large metal spatula until cooked to a light brown. The thicker pieces of steak, due to their need to be cooked more thoroughly, will be set in a single layer on the griddle and flipped until brown.

Cheese can be added at the last stage of griddling, placed on the bread before the meat is added, or ladled on top of the sandwich as the last step.

For adding cheese while griddling, the steak is shaped on the griddle so that the roll could cover it, the cheese is laid on top and allowed to melt for a minute, then the roll is placed over the steak and the spatula is used to scoop the entire contents into the roll.

In another method, the cheese is placed along the inner sides of the sliced roll and is either melted beforehand by a warmer or is melted by the heat of the freshly cooked steak. Lastly, melted cheese or Cheez Whiz can be ladled on top of the sandwich.

The sandwich is served in a long roll, typically a 6-inch or 12-inch (15 or 30 cm) loaf of Italian bread (also known in Philly as a hoagie roll). The bread is sliced lengthwise to form a cradle, similar to a hot dog bun.

A cheesesteak may include other optional ingredients such as fried onions, sautéed green peppers, and mushrooms. Some menus include mayonnaise, hot sauce, ketchup, or pizza sauce (a Pizza Steak, often with mozzarella as the cheese).

Numerous variations on the basic cheesesteak theme are offered by various vendors.

A steak sandwich topped with pizza sauce and sliced or crumbled mozzarella constitutes a pizza steak, which is often placed briefly in a pizza oven or under a broiler to melt and lightly brown the cheese. Some establishments offer sliced pepperoni as an optional topping, to make a pepperoni pizza steak.

A cheesesteak made with chicken is called a chicken cheesesteak and can be served with honey mustard. When served with buffalo wing sauce and bleu cheese dressing, it is called a buffalo chicken cheesesteak, drawing culinary inspiration from two cities in the United States.