Fixed propeller-type turbines are generally used for large units at low heads, resulting in large diameters and slow rotational speeds. As the name suggests, a propeller-type turbine runner looks like the very large propeller of a ship except that it serves the opposite purpose: power is extracted in a turbine, whereas it is fed into a marine propeller. The central shaft, or hub, may have the propeller blades bolted to it during on-site assembly, thus permitting shipment by sections for a large runner. At low heads (below about 24 metres), vertical-shaft propeller turbines typically have a concrete spiral inlet casing of rectangular cross section. Inlet guide vanes are either mounted on a ring or, in large units, set individually directly into the concrete. The flow passage can be increased or decreased by servomotor-driven wicket gates. The kinetic energy leaving the runner can be partially recaptured by a draft tube, a conical diffusing exit section where the velocity is decreased while the pressure is increased. This leads to improved efficiency by keeping the loss of kinetic energy in the exit, or tail, section of the installation to a minimum.

Propeller turbines are used extensively in North America, where low heads and large flow rates are common. For example, there are 32 propeller turbines in the Moses–Saunders Power Dam on the St. Lawrence River between New York and Ontario—16 operated by the United States and 16 by Canada, with each turbine rated at 50,000 kilowatts. With such large plants it is possible to run each turbine at or near its most efficient output by switching complete units in or out as the load fluctuates, in addition to regulating each unit.

If the head or the water flow rate tends to vary seasonally, as occurs in many river systems, an installation with only a few propeller turbines might have to operate all units at partial output under average flow and load conditions. The energy-conversion efficiency of a conventional propeller turbine decreases rapidly once the turbine load drops below 75 percent of its rating. This performance loss can be minimized by varying the inlet-blade angle of the runner to match the runner-inlet conditions more accurately with the water velocity for a given flow. In such a Kaplan turbine each blade can be swiveled about a post at right angles to the main turbine shaft, thus producing a variable pitch. The angle of the blades is controlled by an oil-pressure operated servomotor, usually mounted in the rotor hub with the oil fed through the generator and turbine shaft. The servo-control system, which also drives the gates through a cam or rocker arrangement, is designed to adjust angles and inlet flows to match the electrical load while keeping the main shaft with its directly coupled generator rotating at constant speed. Runners with four to six blades are common, though more blades may be used for high heads. British manufacturers have developed Kaplan designs for heads up to 58 metres.

Although the usual turbine installation has a vertical shaft, some also have been designed with horizontal shafts. In a horizontal bulb arrangement, the generator is embedded in a nacelle, corresponding to the thick body of a light bulb, while the blades are set around a hub corresponding to the thinner bulb socket. This design is suitable for medium-sized machines operating at very low heads when an almost straight-through water flow is desirable. The Rance River tidal plant in France employs this kind of arrangement (see below Tidal plants).