Compared to electronic movements, mechanical ones are less accurate, often with errors of seconds per day, and they’re suffer from sensitivity to position and temperature. They’re also expensive to make, require regular maintenance and adjustment, and are more likely to fail. Nevertheless, those who like the "old world" craftsmanship of mechanical watches still prefer the higher-end models from companies like Omega, Patek Phillipe, Breitling, and Yaeger-Le Coultre.

Mechanical movements use an escapement mechanism to control and limit the unwinding of the spring, converting what would otherwise be a simple unwinding, into a controlled and periodic energy release. Mechanical movements also use a balance wheel together with the balance spring, also known as a hairspring, to control motion of the gear system of the watch similar to what a pendulum does in a clock.

An optional part for mechanical movements called a tourbillon, is a rotating frame for the escapement which watchmakers employ to reduce the effects of bias to the timekeeping. Tourbillons are very expensive because of their complexity, so only high-end watchmakers use them.

The pin-lever, called a Roskopf movement after its inventor Georges Frederic Roskopf, is a less expensive version of the fully-levered movement manufactured by many Swiss manufacturers as well as Timex, until they replaced it with a quartz movement.