Okonomi-yaki consists of a batter grilled on a hot plate with diced cabbage, sliced pork (or other meat), shrimp (or other seafood), eggs, and other ingredients. Once grilled, this pancake-like food is topped with a special sauce, mayonnaise, katsuo-bushi (dried fish shavings) and aonori (finely grated dried seaweed). As opposed to Hiroshima style okonomi, in which the batter and ingredients are grilled separately, Osaka style okonomi-yaki is mixed in a bowl before grilling.

Although okonomi-yaki is easily made at home, Osakans often go to okonomi-yaki restaurants for their special tastes. Popular okonomi-yaki chains are Chibo and Fugetsu. Another restaurant with a long tradition is Boteju, which has been in business for over fifty years.