The title is a play on the term "wife swapping", a practice associated with the swinging lifestyle, which is not a theme of the show. For the television show, two families, usually from vastly different social classes and lifestyles, swap wives/mothers for two weeks. In fact, the show will usually deliberately swap wives with extreme polar opposite lifestyles, such as a dramatically messy wife swapping with a fastidiously neat one. Though using a phrase from the swinging lifestyle, couples participating in the show do not share a bed with the "swapped" spouse while "swapping" homes.

During the first week, the new wife must adhere to the exact same rules and lifestyle of the wife they are replacing. Each wife leaves a house manual which explains their role in the family and the duties they hold.

During the second week, the new wives are allowed to establish their own rules, and their new families must adhere to these new household rules.

At the end of the two weeks, the two couples all meet together for the first time, and along with their husbands, discuss how they feel about the two weeks. This often descends into personal insults and has degenerated into violence at least once. In 2006 on the American version, a new twist was added whereby the wife can bring in someone to help her (a family member, a friend) to help on one day of the swap. The twist was discontinued early in the third season and only appeared in a few episodes.