[5] Macedonian Prime Minister Zoran Zaev vowed to push forward with the changes in the Assembly,[6] which was achieved on 19 October 2018, when 80 of the 120 MPs voted in favour of the renaming proposal, narrowly reaching the two-thirds majority required.

However, in 2018, high-level contacts between the governments of the two countries intensified, with Macedonian Deputy Prime Minister Bujar Osmani visiting Athens for name talks on 9 January,[8] and Macedonian Prime Minister Zoran Zaev meeting with his Greek counterpart Alexis Tsipras on the sidelines of the World Economic Forum at Davos, Switzerland on 24 January.

[9][10][11] At the Davos meeting, the first of its kind in seven years, there appeared to be some resolution between the two leaders to end the name dispute and improve the relations between the two countries.

[17] The agreement was signed at Lake Prespa, a body of water shared between Albania, Greece and North Macedonia from which it got its name.

[18] After a month long delay by the opposition party VMRO-DPMNE to slow down the referendum preparation by not appointing members to the State Election Commission, the Assembly finally agreed as of the end of July on a new composition.

[32] The main opposition party VMRO-DPMNE threatened to boycott the referendum and claimed the Prespa agreement to be an act of treason.

However, in early September, VMRO-DPMNE president Hristijan Mickoski made a statement encouraging citizens to vote as they saw fit, and that the party would respect different opinions.

[35] This was denied by media close to the party,[36][37] which stated that VMRO-DPMNE was only willing to accept changing the FYROM reference to North Macedonia, while keeping the constitutional name the same.

On 23 September, President Gjorge Ivanov, who was elected as the VMRO-DPMNE candidate, decried the agreement and called on citizens to boycott the vote.

[39] Various diplomats and analysts,[40] including U.S. Defense Secretary Jim Mattis,[41] have accused Russia of engaging in a campaign to undermine the referendum.

The European Union's Commissioner for Neighbourhood and Enlargement Negotiations, Johannes Hahn, called the "Yes" vote "very significant" and urged Macedonia's political leaders to "respect this decision and take it forward with utmost responsibility".

A total of 80 deputies in the 120-seat Assembly voted in favour of the renaming proposal, just reaching the two-thirds majority needed to enact constitutional changes.