It was held to elect the governor of North Sumatra along with their deputy, whilst members of the provincial council (Dewan Perwakilan Rakyat Daerah) will be re-elected in 2019.

Candidates were former Governor of Jakarta Djarot Saiful Hidayat and former commander of Kostrad Lt. Gen Edy Rahmayadi.

[6] Under regulations, candidates are required to secure the support of a political party or a coalition thereof comprising at least 20 seats in the regional house.

[15][16] Djarot Saiful Hidayat, who lost as a running mate in the 2017 elections in Jakarta and briefly became its governor following the incarceration of Basuki Tjahaja Purnama, was declared by PDI-P as their candidate on 5 January 2018.

[18][19] Also registering as early as August, J.R. Saragih who was also the regional chair of Demokrat obtained official support on September.