The pilgrimage occurs four times every twelve years, once at each of the four locations. Each twelve-year cycle includes the Maha (great) Kumbha Mela at Prayag, attended by millions of people, making it the largest pilgrimage gathering around the world.

Kumbha Mela is attended by millions of people on a single day. A ritual bath at a predetermined time and place is the major event of this festival. Other activities include religious discussions, devotional singing, mass feeding of holy men/women and the poor, and religious assemblies where doctrines are debated and standardized. Kumbha Mela (especially the Maha Kumbha Mela) is the most sacred of all the Hindu pilgrimages. Thousands of holy men/women (monks, saints, sadhus) grace the occasion by their presence. The suspiciousness of Kumbha Mela is in part attributed to the gathering of thousands of holy men/women at one place on earth.

The observance of Kumbha Mela is based upon the following story : thousands of years ago, perhaps in the Vedic period, gods and demons made a temporary agreement to work together in obtaining amrita (the nectar of immortality) from the Milky Ocean, and to share this equally. However, when the Kumbha (pot) containing the amrita appeared, the demons ran away with the pot and were chased by the gods. For twelve days and twelve nights (equivalent to twelve human years) the gods and demons fought in the sky for the possession of this pot of amrita. It is said that during the battle, drops of amrita fell on to four places : Prayag, Haridwar, Ujjain and Nasik. Thus, Kumbha mela is observed at these four locations where the nectar fell.

In 2003, 39 were trampled dead during Kumbha Mela festival.