Ironi Kiryat Shmona and Hapoel Ashkelon were directly promoted to the 2010–11 Israeli Premier League after finishing the 2009–10 season in the two top places.
Maccabi Ahi Nazareth and Hapoel Ra'anana were directly relegated to the 2010–11 Liga Leumit after finishing the 2009–10 season in the bottom two places.
^A The club played their home games at a neutral venue because their own ground did not meet Premier League requirements.
Hapoel Petah Tikva, the winner on aggregate earned a spot in the 2011–12 Israeli Premier League.
The 14th-placed Hakoah Ramat Gan faced the 3rd-placed Liga Alef team Maccabi Kabilio Jaffa.