Despite boasting several current or future England internationals, including David James, Trevor Sinclair, Joe Cole, Jermain Defoe, Glen Johnson and Michael Carrick, a disastrous start to the season saw them win just three out of their first 24 matches, and the club found themselves bottom of the table at Christmas with just 16 points.

[1] Similarly poor results followed into the new year, as the club continued to struggle in the relegation battle and were knocked out of the FA Cup after a 6–0 defeat to Manchester United in January.

Their poor form in all competitions was put into perspective on 21 April 2003, when manager Glenn Roeder collapsed after a 1–0 Premiership win against Middlesbrough; it was revealed he was suffering from a non-malignant brain tumour, which was later operated on successfully.

[2] Following this, club legend Sir Trevor Brooking was named as caretaker manager, and West Ham's luck began to turn with a series of good results towards the end of the season that saw them go into the final day with a chance of staying up.

However, a 2–2 draw with goals from Les Ferdinand and Paolo Di Canio saw the Hammers relegated after Bolton defeated Middlesbrough 2–1 at the Reebok Stadium, sending them down to England's second division for the first time since 1992.