Fixtures were released on 4 September 2018 and the opening round of matches was played on 19 October 2018.
Promoted from the Third Division Relegated from MS League Promoted to MS League Relegated to the Third Division 1: ^ Al-Akhdoud will play at Prince Sultan bin Abdul Aziz Stadium due to the ongoing war in Yemen The number of foreign players is limited to 2 per team.
[6] Al-Thoqbah defeated Al-Taqadom 3–1 after extra time to finish in third place.
The winners of each group will play a one-legged final to decide the champion of the 2018–19 Second Division.
The match was scheduled to be played on 12 April 2019, but was abandoned after 32 minutes due to heavy snowfall.