The traditional cotton swab has a single tip on a wooden handle, and these are still often used, especially in medical settings. They are usually relatively long, about 6 inches (15 cm). These often are packaged sterile, one or two to a paper or plastic sleeve. The advantage of the paper sleeve and the wooden handle is that the package can be autoclaved to be sterilized (plastic sleeves or handles would melt in the autoclave). Sterilized cotton swabs manufactured for home use are usually shorter, about 3 inches (7.6 cm) long, and usually double-tipped. The handles were first made of wood, then made of rolled paper, which is still most common (although tubular plastic is also used). They are often sold in large quantities, 100 or more to a container.

The most common use for cotton swabs is to clean the ear canal by removing earwax. Cotton swabs are also commonly used for applying and removing makeup, as well as for household uses such as cleaning and arts and crafts. They are also handy for touching up nail polish that gets on the surrounding skin.

Medical-type swabs are often used to take microbiological cultures. Pharmaceutical grade cotton swabs are necessary for medical applications.[4] These medical grade swabs are rubbed onto or into the infected area, then wiped across the culture medium, such as an agar plate, where bacteria from the swab may grow. They are also used to take DNA samples, most commonly by scraping cells from the inner cheek in the case of humans. They can be used to apply medicines to a targeted area, to selectively remove substances from a targeted area, or to apply cleaning substances like Betadine. They are also used as an applicator for various cosmetics, ointments, and other substances.

A related area is the use of swabs for microbiological environmental monitoring. Once taken, the swab can be streaked onto an agar plate, or the contents of the tip removed by agitation or dilution into the broth. The broth can either then be filtered or incubated and examined for microbial growth.Cotton swabs are also often used outside of the field of personal hygiene.They are often used in the construction of plastic model kits, for various applications during the application of decals or painting. Special brands of cotton swabs exist for this purpose, characterised by sturdier cotton heads and varied shapes of those heads.

They can be used in the dyne test for measuring surface energy. This use is problematic, as manufacturers differ in the binders they use to fix the cotton to the stem, affecting the outcome of the test.They are frequently used for cleaning the laser diode lens of an optical drive in conjunction with rubbing alcohol. Similarly, they are used for cleaning larger computer parts such as video cards and fans. They were also widely used in the past to clean video game cartridges. Cotton swabs are also commonly used for applying and removing makeup, as well as for household uses such as cleaning and arts and crafts. They are also handy for touching up nail polish that gets on the surrounding skin. Medical-type swabs are often used to take microbiological cultures.