Every April 18, hundreds of people meet at Lotta's fountain on Market Street at 5:11 a.m. to drape a wreath on the fountain.
They then go to 20th Street to repaint the fire hydrant that saved the churches in the Mission District from the fires that ravaged the city for three days after the temblor.
The commemoration ends with a Bloody Mary breakfast and movie screening at restaurant Lefty O'Doul's downtown.
One of the last remaining earthquake survivors, 104-year-old William Del Monte, was scheduled to attend this year's event.
"There's a certain sense of optimism that is in every (survivor) that I've met," event organizer Lee Houskeeper said. "Sort of a 'We can do anything' attitude. They rebuilt the city from ashes. They have an incredible sense of humor."
Houskeeper has kept track of earthquake survivors for the past 25 years and believes about eight are still alive.
He also oversees the current earthquake commemoration ceremony, which was inspired by a now-defunct fraternal order called the South of Market Boys. The South of Market Boys began placing wreaths at Lotta's fountain in 1919.
Lotta's fountain was a popular gathering place and outdoor concert site in the early 20th century, Houskeeper said. After the earthquake, it became a focal point of city.
"People would say, 'Go check on mom and then meet me at Lotta's fountain,'" Houskeeper said. "Or they would put up notes there looking for so-and-so."