Kelty Hearts were the reigning champions but could not defend their title after being promoted to the Lowland Football League.
The additional teams consisted of 24 clubs who applied to switch from the SJFA East Region, one from the SJFA West Region, one new team and Hawick Royal Albert who were relegated from the Lowland League.
The winners of each conference took part in a round-robin competition at the end of the season, with Bonnyrigg Rose Athletic being crowned league champions on 4 May 2019 after winning both their championship play-off matches.
They later clinched promotion to the Lowland League after gaining their SFA licence on 14 June 2019.
[45][46] Bonnyrigg Rose Athletic were crowned champions after winning both of their matches, and later gained promotion having eventually received their SFA licence on 14 June 2019.