[1] Olimpia were the defending champions after winning both tournaments of the 2018 season, and won a third championship in a row in the Torneo Apertura with three matches to spare after defeating Deportivo Santaní by a 6–0 score on 4 May.
[2] Olimpia also crowned themselves in the Torneo Clausura, winning a fourth title in a row with one matchday remaining, following a 2–2 draw at home against Guaraní on 8 December.
The new teams were 2018 División Intermedia champions River Plate and runners-up San Lorenzo, who returned to the top flight after two and three years, respectively.
Note: Teams occasionally play their home games at Estadio Defensores del Chaco in Asunción.
[4] They played their Torneo Apertura home game against San Lorenzo at Estadio Erico Galeano in Capiatá.