Hapoel Kfar Saba and Sektzia Nes Tziona were promoted to the 2019–20 Israeli Premier League.
Maccabi Petah Tikva and Bnei Sakhnin were relegated after finishing as the two bottom-placed clubs in the 2018–19 Israeli Premier League.
They were replaced by the top placed teams from each division of 2018–19 Liga Alef, F.C.
^A The club is playing their home games at a neutral venue because their own ground does not meet league requirements.
The winner of the Relegation decider game , Hapoel Afula, faced Liga Alef promotion play-offs winner Hapoel Marmorek .