Defending champions Valletta won their 25th title, following a penalty shootout win against Hibernians in a championship decider match.
[4] Lija Athletic and Naxxar Lions were relegated after they finished thirteenth and fourteenth the previous season.
[5] They are replaced by Qormi and Pietà Hotspurs, the 2017–18 Maltese First Division champions and runners-up respectively.
Tarxien Rainbows retained Premiership status by defeating Żejtun Corinthians in a play-off decider.
At the end of the season, Valletta and Hibernians finished off equal on 58 points; in the last matchday, Valletta were few minutes away from winning the title as they were leading 1–0 against Ħamrun Spartans, but a goal in stoppage time levelled the match.