Painting a Thangka usually starts by stretching a piece of cotton cloth on a wooden frame along its sides. Then, a certain type of gesso is spread over both the front and back of the canvas to block the holes and then scraped off to produce smooth surfaces. Afterwards, some orienting lines are drawn to guide the sketching. By following a fixed proportion, images are then roughly drawn. The featured deity or saint occupies the center while other attendant deities or monks surround the central figure and along the border, and is comparatively smaller in size. Next is coloring. Painters apply pigments on the sketch. Black, green, red, yellow and white are the basic colors used in coloring. Shading is then done to produce better pictorial effects. At the final stage, facial features and eyes are finished, which is sacredly done only after a ritual held on a fixed day. After detail finishes, the canvas is removed from the frame and mounted on a piece of brocaded silk. The wooden sticks are attached to the top and bottom of the silk. After a dust cover of gossamer silk is attached it is ready to be hung up.

Karma Gadri tradition and Menri Karma Gadri tradition are the two major schools of Tibetan Thangka Painting.