At first glance the Tzimisce seems a fractious, individualistic clan, mirroring the anarchic sect its members founded. This perception is entirely inaccurate. Despite its lack of formal structure, the clan is very tightly bound. Respect for sect and heritage pervades the Tzimisce, and the vagaries of Vicissitude virtually dictate a fair degree of individual self-expression within the communal structure. Then, too, many members are bound by Vinculums established during clan fetes.

What little hierarchy exists among Sabbat Tzimisce is based solely on power. Tzimisce who have awakened their zulo shape (i.e.:, have achieved the fourth level of Vicissitude), who have at least one level of Thaumaturgy, and who have demonstrated wisdom and loyalty to the sect and clan are known among the clan as zhupans. Zhupans are respected for their knowledge and power, and may "suggest" courses of action to lesser Tzimisce. The lesser Tzimisce are not required to heed a "suggestion," but ignoring a zhupan is considered extremely rude and will almost inevitably alienate the zhupan so snubbed.

The head of the Tzimisce clan as a whole is called Voivode. Though this title carries no official weight in the Sabbat, in practice the Voivode is accorded roughly the same amount of status that a cardinal is given. Voivode is more of a religious office than a secular one. It is the Voivode who decrees the clan's Auctoris and Ignoblis Ritae and who supervises the clan's sacred nights. The Voivode is always formidably proficient in both Vicissitude and Thaumaturgy, extraordinarily self-aware (i.e.:, has nearly mastered her Path of Enlightenment), and extremely wise. The only symbol of office is a cape fleshcrafted from the skins of at least three Tremere vampires slain in personal combat.

Battles for the position almost never occur; when they do, the contestants take zulo form and engage in a physical and magical Monomacy to death or submission.