As no candidate received more than 50% of the vote, a run-off round was held on 5 April 2009,[1] which was won by Gjorge Ivanov of the center-right VMRO-DPMNE party.

[12] A fair and democratic election has been seen as an important factor for Macedonia's induction to NATO and the European Union.

In the first round, Ivanov strongly led in front of the other candidates with 35%, with Frčkoski getting 20% and coming in second place and advancing to the run-off.

[16] In part due to the existence of many voters in the registers who have left Macedonia years ago and live abroad, and in part due to the lack of motivation for ethnic Albanians to participate in the second round, there were fears that the minimum turnout of 40% might not be met in the second round, invalidating the election.

[18] It was also reported that on thousands of ballots names like "Chuck Norris", "GOD", "Jimi Hendrix" or "George Bush" were hand-written by the voters.