Marsa and Mosta were relegated from Maltese Premier League.
Tarxien Rainbows and San Gwann were promoted from Maltese Second Division with the latter (San Ġwann) having won a promotion playoff against Vittoriosa Stars.
St. Patrick were the champions while Lija Athletic were runners-up.
Tarxien Rainbows and Rabat Ajax were relegated to Maltese Second Division with the former having just clinched promotion only to go straight down again.
The Maltese First Division 2003–04 was made up of these teams: For a complete set of results, see 1