To start let me share why I use pinterest (if anyone would like to share in the comments why they use twitter, i am all ears). First I just love images. I am a visual person so for me it is by far my most favorite social media outlet. People are generous on pinterest, if you post a pin that they like they will repin it without hesitation - this can be really helpful in bringing more traffic to your business, your blog or your brand - if that is a goal. Pinterest is full of inspiration. When I am in a funk creatively I will often find images that inspire me and motivate me to be creative offline. Whether that be in an creative sense, or just looking for ideas on how to organize under my sink, find a recipe, or what colors look fantastic together - it's all there. Basically I use it as a curation of my favorite images and things, inspiration board and also as visual bookmarker.
Step Two: Create your own boards. When you get your account pinterest will have some boards already for you to start pinning on like 'products I love.' But to make it more personal you can rename boards, erase boards, add boards and even have up to three secret boards that only you can see. I use the secret boards to pin ideas for my blog such as house tours I want to feature at some point. I also use it a lot to pin gift ideas for Christmas & birthdays and such. It's a newer feature and one of my favorites!
At first I used the stock boards but as I started pinning more and more I changed them up and added my own. So if you love photography you can create and dedicate a board just for those pins. If you love bunnies you can create a board just for cute bunny pictures. Just start and remember you can personalize and organize anytime down the road.
Step Three: Find people to follow. My pinterest account is mostly filled with interior design images so many of the people I follow are people who also share a similar aesthetics and interests. When I find a pinner I really love I will go to their account page and see who they pin from the most (it's in the top right corner of their account page under "repins from") chances are I am going to love the people they love. Also look for accounts from bloggers that you follow, magazines you read, or use the search bar to find images you like and follow them back to the accounts - you may find one image leads you to an account you want to follow.
Step Four: Start pinning. This seems simple enough but if you have a blog/website/brand you may want to only pin images that reflect your overall brand aesthetic. Pinterest has quickly become another venue for brand identity. If your blog is dedicated mostly to recipes, it makes a lot of sense that those reading your blog do so because you write about food. They see you as an expert or resource on cooking - so it also makes sense that your pinterest account reflect that too. Those same people that read your blog will likely follow you on pinterests and people on pinterest that find your recipe pins may start following your blog. This doesn't mean you only have to pin recipes by any means, but it does mean you can expand your brand identity using pinterest. With that you may want to have other boards dedicated to baking, kitchen accessories, food styling, and so on.
Some people have very specifically curated accounts. A great example is Jennifer Hagler whose boards are very monochromatic. I love her account and it is clearly a reflection of her brand identity, but having followed her for along time, I know what you see now is something that has developed over time. She also has a board devoted to her blog and her jewelry line which I think it a great idea and strengthens her brand identity. An another example of a pinner I love is Beth Kirby, her account is not as "defined" but the overall feel and style is one that definitely represents her. Beth Kirby's blog Local Milk, is mostly dedicated to food and photography - which I think is obvious that she believes both are good for your soul. She also pins just about everything else you can image but it all has that same feeling of soulfulness. And just remember if you are interested in keeping your pins and boards within a specific parameter you have the three private boards to use too.
As far as just pinning goes I do so from "repinning" images from people I follow, using the search tool, and also from using the "pin it" button where I pin images from websites and blogs.
Step Five: Organize. Once you have been pinning away for awhile you can begin organizing. This is always on my to-do list and I have done this several times since I have been on Pinterest. For example, now that you have pinned 200 pins to your photography board, recipe board and interiors board maybe you decide you want to break your boards down into: black and white photography or cocktails or dining rooms. You can easily edit pins (using the edit pen icon button) to move them to new or different boards. You can also change the image of your boards covers to give an overall feeling of curation.
Pinning With A Purpose: How Artists Use Pinterest
How To Use Pinterest : 17 Useful Tips
How To: Create Custom "Pin It" Button on Images
How To: Verify Your Website (on pinterest)