The ballot saw the election of Military leader General Adde Muse as the third president of Puntland, narrowly defeating Mohamed Abdi Hashi.

In November 2001, Abdullahi Yusuf Ahmed, the first president of Puntland, was forcibly removed from the capital by the opposition after he refused to leave office despite his term expiring.

In 2003, Mohamud Muse Hersi Adde, a former Lieutenant general, organized a militia group consisting primarily of members from the Osman Mohamoud sub-clan of Majeerteen.

In response to the escalating conflict, traditional elders from Puntland intervened and facilitated a peace agreement between General Adde Muse and Abdullahi Yusuf Ahmed.

The peace agreement, signed in May 2003, led to a collaboration between the two leaders, with their forces combining and power being shared between them, Ahmed then regained the presidency and served his second term from 2003, until October 14, 2004.