To create a PowerPoint presentation from scratch, go to the "File" menu and select "New presentation" to start with a blank template. Alternatively, you can choose a pre-made template under "New from template" to focus only on content. Presentations are organized into slides that can be further divided into sections for grouping related slides. When adding new slides, the layout can be selected using the arrow button next to the "New slide" option to choose designs suited for different media like videos. Formatting tools allow customizing text, inserting images and objects, and arranging content. Transitions between slides and animations within slides can make the presentation more engaging for audiences.