Basketball in the Big South Conference culminates at the Big South Conference Men's Basketball Tournament, also known simply as the Big South Tournament. Ever since 1986, the competition has been an annual tradition. The event features a single elimination bracket and uses regular season records to determine seeding. The conference tournament winner is given the automatic bid to the NCAA Division I Men's Basketball Tournament. In contrast, the conference did not get an at-large bid to the NCAA tournament in 1986, 1990, or 1995.

Campbell left the Big South Conference before the 1994–1995 season because of scheduling difficulties. This meant the conference only had five teams with at least five years of Division I experience, short of the six needed to get an automatic berth into the NCAA tournament as mandated by the NCAA. So, for the first time since 1990, the Big South did not send an automatic qualifier to the NCAA Tournament that year; however, the conference got its automatic bid back in 1996 and has kept it every year since then (through 2020-21).

Between 2003 and 2012, the competition was primarily hosted by universities. The 2003 semifinals and finals were held at a single, specified location. The regular season champion then hosts the following year's final or semifinals and final.

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