Bo'ness United were the reigning champions but could not defend their title after being promoted to the Lowland Football League.
The start of the league season was delayed until October 2020 because of the COVID-19 pandemic, and games were played behind closed doors due to Scottish Government restrictions.
On 11 January 2021 the league was suspended by the Scottish Football Association due to the escalating pandemic situation.
Therefore all clubs remain in the Premier Division (except promoted Bo'ness United) along with the winners of First Division Conference A and B (Lothian Thistle Hutchison Vale and Tynecastle), plus the runners-up with the best points per game record (Inverkeithing Hillfield Swifts).
The 31 First Division clubs were assigned a place in Conference A or B based on their performances in the 2019–20 season.