With cupping, usually a flammable substance such as alcohol is used to place inside the cup to remove the oxygen. As the fire goes in the cup, it is then placed upside down onto the patient's skin; the fire is able to create a vacuum to cause the skin to raise up as the blood circulation to that area increases and blood vessels expand to cause redness.

The cups are left on the skin for around 5–10 minutes. They are either stationary cups, which are left in place, or the practitioner may slide or glide the cups over the area. After cupping, there may be bruising on the surface of the skin which eventually subsides but can last up to several days. These purple/red cupping marks are an indication of toxins and cold-damp that was accumulated under the skin's surface that are now being removed.