The birthday cake is traditionally highly decorated, and typically covered with lit candles when presented, the number of candles signifying the age of the celebrant. The person whose birthday it is may make a silent wish and then blow out the candles. After that, the person can open their presents. It is also common for the person celebrating their birthday to cut the initial piece of the cake as a newlywed couple might with a wedding cake.

Each item was associated with a prediction. For example, a person finding a gold coin in a birthday cake would supposedly become wealthy; a person discovering a thimble would never marry.

Sometimes special candles are substituted for the many individual candles in the shape of a numeral. For example, on the first birthday, there may be one candle on the cake in the shape of the numeral one, and on the tenth birthday there may be two candles on the cake, one in the shape of the numeral one followed by the other in the shape of the number zero.

In addition to parties, it is common for people to receive gifts on their birthdays or surprise parties. The popular gifts include toys, books, jewellery, clothes, flowers, technical devices, etc. However, sometimes it is expected of the person celebrating their birthday to treat their party guests instead; this varies depending on the local culture and may involve party gifts or other gestures, for example inviting to the restaurant or bar (some of them offer special birthday programs), arranging party at home, or at work. The origin of the birthday gift giving originates from the gift giving celebration of Christmas.

In most English-speaking countries it is traditional to sing the song "Happy Birthday to You" to the honored person celebrating a birthday. Happy Birthday songs are common worldwide. Similar songs exist in other languages such as "Zhu ni sheng ri kuai le" in Mandarin Chinese, "Lang zal hij/zij leven" in Dutch, "Õnne soovime Sul" in Estonian, "Zum Geburtstag Viel Glück" in German, "Nα ζήσεις και χρόνια πολλά " in Greek, "Hayom Yom HUledet" in Hebrew, "Que los cumplas feliz" or "Feliz cumpleaños a ti" in Spanish, "Parabéns a você" in Portuguese, "Maligayang Bati" in Filipino, "Sto lat" in Polish, "Lá Breithe Shona Duit" in Irish, "multi ani traiasca" in Romanian, "Ja må du leva" or "Med en enkel tulipan" in Swedish, "Joyeux Anniversaire" or "Bonne Fête" in French, "Tanti Auguri a te" in Italian and "Iyi ki dogdun, Mutlu Yillar Sana" in Turkish.This song is a common greeting used on birthdays, along with greeting cards and verbal greetings with messages such as "I wish you a Happy Birthday" or "Happy Birthday."

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