In the United States and Canada (except Quebec), the main course is traditionally called an "entrée". English-speaking Québécois follow the modern French use of the term entrée to refer to a dish served before the main course.
According to linguist Dan Jurafsky, North American usage ("entrée") retains the original French meaning of a substantial meat course.
The main dish is usually the heaviest, heartiest, and most complex or substantial dish in a meal. The main ingredient is usually meat, fish or another protein source. It is most often preceded by an appetizer, soup or salad, and followed by a dessert. For those reasons the main course is sometimes referred to as the "meat course".
In formal dining, a well-planned main course can function as a sort of gastronomic apex or climax. In such a scheme, the preceding courses are designed to prepare for and lead up to the main course in such a way that the main course is anticipated and, when the scheme is successful, increased in its ability to satisfy and delight the diner. The courses following the main course then calm the palate and the stomach, acting as a sort of dénouement or anticlimax.