A common practice is to dip the inner sides of a split biscuit into the gravy in order to add flavor and keep the biscuit from being too dry when a piece of country ham is added between the two halves: the Southern "ham biscuit" (although the Appalachian ham biscuit is simply a biscuit with country ham). Another popular way to serve red-eye gravy, especially in parts of Alabama, is with mustard or ketchup mixed in with the gravy. Biscuits are then "sopped" in the gravy.
In Louisiana, Cajun-style gravy is often made with a roast beef instead of ham. Black coffee is always used, and it is frequently a strongly brewed chicory coffee. The gravy is ladled over the meat on a bed of rice, staining the rice a dark brown color. Often, French bread and some kind of beans are also served as a side, like butter beans (lima beans) or peas.
The Mississippi variation uses red wine in the place of coffee.
Red Eye Gravy's name likely comes from the appearance of the gravy. Prepared traditionally, when coffee and grease are not combined until the end (see Preparation, below) the coffee and grease form a heterogeneous mixture, with the water-based coffee sinking to the bottom and the oil-based grease forming the top layer. In a round bowl, therefore, the mixture looks much like a red eye, the coffee giving the red hue and the grease looking like a human iris.
Less traditional preparation techniques do not always result in the "red eye" appearance, leading to folk legends surrounding the origin of the name. For instance, that former United States President Andrew Jackson requested ham with gravy as red as his cook's eyes, which were bloodshot from drinking the night before, or that the black coffee in the gravy will keep people awake.
Other recipes exist, using water instead of coffee, or adding coffee with grease still present in the pan.