The Creation King appears as a giant floating heart within Gorgom's lair, communicating with its followers via telepathy. It remained hidden for most of the series up until the two final episodes.
Every 50,000 years, the existing Creation King dies and two Century Kings are chosen to duel each other. The winner of the duel claims both King Stones after killing the loser, thus becoming the new Creation King to rule Gorgom for the next 50,000 years. It is for this that Kohtaro Minami and Nobuhiko Akizuki were chosen.
At the end of the series, after defeating Shadow Moon, Kamen Rider Black confronts the Creation King, who prepares to lower himself into the Earth to destroy it. However, before it can do so, the Creation King is destroyed Black, ending Gorgom's reign of terror.