Twin Falls First Presbyterian Church is a member of The Presbyterian Church U.S.A. or PC(USA), which is a mainline denomination based in Louisville, Kentucky. With about 2 million members, the Presbyterian Church U.S.A. is one of the largest denominations in the United States. PC(USA) resulted from the 1983 merger of two theologically liberal churches: the Presbyterian Church in the United States and the United Presbyterian Church in the United States of America. The Presbyterian Church U.S.A. is distinct from the Presbyterian Church of America (PCA) and the Evangelical Presbyterian Church (EPC), and it’s important not to confuse the denominations, since they represent very different views of Scripture, morality, and politics.

All Presbyterian churches, including the Presbyterian Church (USA), have their roots in the Protestant Reformation of the 16th century, specifically the work of John Knox in Scotland who studied under Calvin. PC(USA) looks to two sources for guidance: the Bible and the Constitution of the PC-USA. The constitution is comprised of two parts: the Book of Order and the Book of Confessions.

In the early 20th century, Presbyterians drafted the Six Great Ends of the Church. These appear in the Book of Order (F-1.0304):

1) The proclamation of the gospel for the salvation of humankind

2) The shelter, nurture, and spiritual fellowship of the children of God

3) The maintenance of divine worship

4) The preservation of the truth

5) The promotion of social righteousness

6) The exhibition of the Kingdom of Heaven to the world

Like other Presbyterian churches, PC(USA) churches are governed by a session at the local level (known in some other Protestant churches as boards), regional presbyteries, and synods. Local congregations elect member to serve on their session for three-year terms. The congregation's pastor moderates the session. Congregations also elect presbyters who form a presbytery to oversee regional groups of local churches. Twin Falls First Presbyterian Church is a member of the Presbytery of Kendall.  Presbyteries are then governed by synods. Twin Falls First Presbyterian Church is part of the Synod of the Pacific, and all the synods together form the General Assembly. The publishing arm of the Presbyterian Church (USA) is Westminster John Knox Press. The denomination is also associated with over 50 schools and universities.