The pudding can be made from scratch using tapioca in a variety of forms: flakes, coarse meal, sticks, and . Many commercial packaged mixes are available also. Uncooked, tapioca pearls resemble pellets of styrofoam; cooked, they resemble .
A common variation involves placing sweetened adzuki bean paste at the bottom. Another is to layer cooked tapioca custard and pieces of fruit. In this case the custard is thick enough that the fruits do not sink or rise to the top.
The pudding is called "Sai mai lo" in Hong Kong as a tongsui dessert. In addition to small pearl tapioca, it has coconut and evaporated milk. Some varieties include taro to make "taro sai mai lo" . Other varieties include fruits such as mango or honeydew. It is served usually cold, sometimes warm.
In Brazil, the dessert ''sagu'' is made from pearl tapioca cooked with cinnamon and cloves in red wine or grape juice.