Between the years 1937 and 1962, Mahmoud Afshar placed the entirety of his real estate holdings into a public endowment by means of five deeds of endowment and according to official jurisprudential and legal regulations. The establishment of Dr Mahmoud Afshar Foundation was in order to realize the aforementioned goals, that were further described and enumerated in a book, entitled "Five Endowments."

Until 1983, this foundation was managed under the trusteeship and management of its endower. However, after Afshar's death in that year, as it has been stipulated in the deed of endowment and approved by the National Organization of Endowments and Charitable Establishments, its management passed on to an eleven-member council of trustees. This council consists of five official trustees, who are: the Speaker of the Islamic Consultative Assembly, the President of the Supreme Court, the minister of health and medical education, the minister of education, and the president of the University of Tehran. Additionally, four professors serve on the council as statutory trustees. The remaining two members are appointed from Mahmoud Afshar’s family. The executive affairs of the foundation are assigned to a five-member board of directors, who serve with the titles of chairman, vice chairman, managing director, treasurer-accountant, and secretary. The members of this board are appointed by the council for trustees for a term of three-years that may be extended or renewed.