The balloons were introduced in 1927, replacing live zoo animals that were featured in the first parade. In 1928, Macy's switched from inflating the balloons with air to helium, making them float. Sarg's large animal-shaped balloons were produced by the Goodyear Tire and Rubber Company in Akron, Ohio from the 1920s through 1980.

In 1928, Sarg released the five balloons, set to leak slowly over the course of a week and then descend, with a reward of $100 (equivalent to $1,770 in 2023) for whoever found them; the reward amount fell to $50 the next year. In 1931, aviation pioneer Clarence Chamberlin spotted a dragon balloon midair, decapitated it with a wingtip, and brought the remnants back to land, where he claimed a $25 award. The practice of releasing the balloons ended in 1932, after a novice pilot attempting the same feat nearly crashed her plane.

The balloons in the Macy's Thanksgiving Day Parade have had several varieties. The oldest is the novelty balloon class, consisting of smaller balloons ranging widely in size and handled by between one and thirty people (the smallest balloons are shaped like human heads and fit on the heads of the handlers). The larger and more popular class is the character balloons, primarily consisting of licensed pop-culture characters; each of these (16 in 2019 ) is handled by exactly 90 people. Since 2005, the "Blue Sky Gallery" has transformed the works of contemporary artists into full-size balloons; a new balloon was featured each year until 2012, and more intermittently since then.

In addition to the well-known balloons and floats, the parade also features live music and other performances. College and high school marching bands from across the country participate in the parade. The television broadcasts feature performances by established and up-and-coming singers and bands. The Rangerettes, from Kilgore, Texas, the world’s first precision drill team, known for their precision dance routines, are also a highlight of the event. The Rockettes of Radio City Music Hall are a classic performance (having performed annually since 1957 as the last pre-parade act to perform, followed by a commercial break), as are cheerleaders and dancers chosen by the National Cheerleaders Association from various high schools across the country. The parade always concludes with the arrival of Santa Claus to ring in the Christmas and holiday season (except for the 1932 parade, when Santa led the parade). Since 2017 until 2023, the Macy's Singing Christmas Tree choir precedes Santa Claus as the final performer of the parade, except 2022 and 2023 when they performed second-to-last.

On the NBC telecast from in front of the flagship Macy's store on Broadway and 34th Street, the marching bands perform live music. Most "live" performances by musicals and individual artists lip-sync to the studio, soundtrack or cast recordings of their songs, due to the technical difficulties of attempting to sing into a wireless microphone while in a moving vehicle (performers themselves typically perform on the floats with the exceptions being the Santa's Sleigh float and the Tom Turkey float); the NBC-flagged microphones used by performers on floats are almost always non-functioning props. Although rare, recent parade broadcasts have featured at least one live performance with no use of recorded vocals.

Every year, cast members from some Broadway shows (usually shows that debuted that year) perform either in the parade or immediately preceding the parade in front of Macy's and before The Rockettes' performance (since NBC broadcasts the parade's start, the performances are shown during the wait for the parade itself). The 2007 parade was notable as it took place during a strike by the I.A.T.S.E. (a stagehands' union). Legally Blonde, the one performing musical affected by the strike, performed in show logo shirts, with makeshift props and no sets. The other three shows that year performed in theaters that were not affected by the strike.

For the 10th anniversary of the September 11th attacks in 2011, the Macy's Thanksgiving Parade invited family members from Tuesday's Children (a nonprofit organization that benefits families directly impacted by terrorism) to cut the ribbon at the start of the parade with NBC's Al Roker and led the parade with Amy Kule, the Parade's executive producer.

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More than 44 million people typically watch the parade on television on an annual basis; in 2024, it was the most-watched television special of the year, outdrawing all of the major awards ceremonies, New Year events and Christmas specials. It was first televised locally in New York City in 1939 as an experimental broadcast on NBC's W2XBS (now WNBC). No television stations broadcast the parade in 1940 or 1941, but local broadcasts resumed when the parade returned in 1945 after the wartime suspension. The parade began its network television appearances on CBS in 1948, the year that major, regular television network programming began. NBC has been the official broadcaster of the event since 1953. As of 2024, NBC pays Macy's $20 million per year for the license to be the parade's official broadcaster; the parade earns a substantial profit for the network, with ad buys averaging $900,000 per 30-second commercial in 2023—a fee comparable to NBC Sunday Night Football—bringing in a gross revenue of $52 million. In November 2024, The Wall Street Journal reported that during negotiations to extend their broadcast contract for the parade and the Macy's Fourth of July Fireworks Spectacular for ten additional years, NBC offered to pay Macy's an increased license fee of $60 million to continue carrying the parade telecast.

At first, the telecasts were only an hour long. The telecast then expanded to two hours in 1961, reduced to 90 minutes in 1962, reverted to two hours in 1965, and expanded to all three hours of the parade in 1969. The event began to be broadcast in color in 1960. NBC airs the Macy's Thanksgiving Day Parade live in the Eastern Time Zone as well as Puerto Rico and the U.S. Virgin Islands, as the network uses broadcast feeds from that time zone (which due to time differences starts at 10:00 a.m. AST), but tape delays the telecast elsewhere in the continental U.S. and territories from the Central Time Zone westward to allow the program to air in the same 8:30 a.m. to 12:00 p.m. timeslot across its owned-and-operated and affiliated stations (except for Guam, which airs it the day after Thanksgiving at 8:30 a.m. local time, as the territory is located west of the International Date Line and therefore a day ahead from the rest of the United States). With the launch of Peacock in 2020 and branded extensions such as a virtual reality broadcast sponsored by Verizon however, it is now possible to watch the parade live across the United States without any tape delay through Peacock, or another international streaming provider with rights to NBC's programming.

Following the morning program's expansion to three hours in 2000 (it eventually expanded to four hours in 2007), NBC's Today aired as an abbreviated two-hour broadcast on Thanksgiving morning, pre-empting the last two talk-focused …

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