Archbishop Willem Jacobus Eijk (Utrecht) wearing an amaranth birettaThe biretta is used by all ranks of the clergy from cardinals to priests, deacons and seminarians. Those worn by cardinals are scarlet red and made of silk. After the Second Vatican Council the ceremony of giving the galero to Cardinals was replaced with giving the biretta. The biretta of a bishop is amaranth, while those worn by priests, deacons, and seminarians are black.

Cardinals bear no tuft or "pom," bishops bear a purple pom, priests who have been appointed as prelates to certain positions within the Vatican wear a black biretta with red pom, diocesan priests and deacons, wear a black biretta with or without a black pom, seminarians are only entitled to wear a biretta without a pom-pom. Priests in religious orders do not usually wear birettas, though the canons of the Order of Prémontré wear a white biretta and the black biretta is also part of the habit of some other congregations of Canons Regular. The Congregation of the Oratory of St. Philip Neri also wear birettas, but without a pom, regardless of rank. The Pope does not make use of the biretta. The liturgical biretta has three peaks, with the 'peak-less' corner worn on the left side of the head.