The hymn tune is first presented by an offstage trumpet to the somber accompaniment of onstage winds and percussion. The procession-like melody is gradually transformed from this dark first statement to one of majesty, and is continued by a pipe organ interruption as a song of praise. Following this, a more plaintive version of the hymn tune is heard, which in turn becomes a fugal alleluia. After a brief climax the music returns to its somber beginnings, but this time with a feeling of hope and purpose. A long crescendo, both in terms of dynamics and instrumentation occurs, and brings the work to a glorious close.
Meditations on an Old Scottish Hymn Tune is dedicated to the memory of the composer's parents.