This was the second consecutive year that the pageant was held in Baltimore, although the venue changed from the Hippodrome Theater to the larger 1st Mariner Arena. Delegates arrived in the city on 2 April 2006, and were involved in three weeks of events, appearances and preliminary competitions before the final competition. This included a trip to New York City to attend a book launch for The Miss Universe Guide to Beauty and make media appearances on Regis and Kathy, The Early Show and Total Request Live.
The pageant hosts were Nancy O'Dell (who had hosted the pageant in 2004 and 2005) and Drew Lachey. For the first time Queer Eye for the Straight Guy star Carson Kressley provided commentary. Special guest performers were the East Village Opera Company.
The finals were broadcast by NBC, with 7.77 million viewers, the second-lowest viewership ever recorded.
Miss USA 2006 was awarded to Tara Conner (Kentucky). The runners-up were:
The Top 10 (in alphabetical order) were Haleigh Stidham (Alabama), Candace Allen (District of Columbia), Leeann Tingley (Rhode Island), Lacie Lybrand (South Carolina), and Lauren Lanning (Texas).
The Top 15 (in alphabetical order) were Brenna Sakas (Arizona), Catherine Warren (Illinois), Katee Stearns (Maine), Lauren Scyphers (Nevada), and Lauren Grissom (Tennessee).
A pre-pageant special edition of Deal or No Deal aired on April 12 on NBC. It included Miss USA 2005 Chelsea Cooley and twenty-six contestants, who replaced the show's models as briefcase-holders: Haleigh Stidham (AL), Kimberly Forsyth (AR), Tamiko Nash (CA), Jeannine Phillips (CT), Ashlee Greenwell (DE), Cristin Duren (FL), Catherine Warren (IL), Bridget Bobel (IN), Tara Conner (KY), Christina Cuenca (LA), Katee Stearns (ME), Tiffany Kelly (MA), Danelle Gay (MI), Dottie Cannon, (MN), Kristi Capel (MO), Lauren Scyphers (NV), Jessica Boyington (NJ), Onawa Lacy (NM), Samantha Holvey (NC), Kimberly Krueger (ND), Tanya Lehman (PA), Leeann Tingley (RI), Lacie Lybrand (SC), Soben Huon (UT), Amber Copley (VA), Jessica Wedge (WV).
Allison Machado (OR) was the alternate.