According to the provisions set forth in the City Charter, Lake Worth operates a Commission-Manager form of government. Authority is vested in an elected City Commission, which, in turn, appoints the City Manager.

The City Commission is comprised of five members who serve staggered three-year terms and are elected on a nonpartisan basis by residents of the City. The Mayor is elected by a city-wide vote to serve a three-year term as the presiding officer at City Commission Meetings and as the official head of the City of Lake Worth for legislative and ceremonial purposes. The City Commission is responsible for passing Ordinances and other policy directives necessary for the operation of the City.