A majority government was formed by the Progressive Conservative Party with leader Doug Ford serving as Premier of Ontario.

[3] The first change to the Cabinet came on November 2, 2018, when Jim Wilson resigned to sit as an independent and Todd Smith assumed his role as Minister of Economic Development.

[9] Doug Downey, Paul Calandra, Stephen Lecce and Ross Romano were promoted to cabinet to be Attorney General, Government House Leader, Minister of Education, and Ministry of Training, Colleges and Universities, respectively.

Bill Walker and Michael Tibollo were demoted from ministerial positions to be Associate Ministers, and Christine Elliott's portfolio split with Merrilee Fullerton taking over the newly created Ministry of Long-Term Care.

[11] The first session of the 42nd Parliament began on July 11, 2018, with the Speech from the Throne delivered by Lieutenant Governor Dowdeswell on behalf of the Premier Ford and the Progressive Conservative government.

The first bill, adopted by the Parliament on July 26, was the Urgent Priorities Act (Bill 2) which enacted back-to-work legislation to end strike action at York University, canceled the White Pines wind project, and required Hydro One create new compensation packages for their chief executive officer and board of directors which would be subject to government approval.

Bill 32 amended the Ontario Energy Board Act to spread of the cost of expanding the natural gas distribution system to all rate-payers rather than those immediately benefiting from the expansion.

Bill 47, Making Ontario Open for Business Act, retracted the planned 2019 increase to the minimum wage while tying future increases to a calculation of inflation, replaced a mandatory provision for all employees to be provided two paid sick days with unpaid leave days, eliminated mandatory pay-equity for part-time and casual workers, deleted the allowance of a trade union to obtain a list of employees and closed the Ontario College of Trades.

[15] Bill 57 was an omnibus bill that made numerous amendments to various acts, including closing the office of the Provincial Advocate for Children and Youth, and the office of the Environmental Commissioner, repeals the Ontario Place Corporation Act and the Trillium Trust Act, expanding the area Metrolinx provides service to while deleting the requirement that it consider all forms of transportation it is plans, exempting the Royal Canadian Legion from property taxes, allowing professional full-time fire-fighters to also work part-time at a different fire department,[16] increasing the maximum allowable contributions that can be made to political parties while removing the prohibition of MLAs from attending fund-raising events, proclaiming March 27, 2019, to be Special Hockey Day, creating a Low-Income Individuals and Families tax credit, closing the offices of the Conflict of Interest Commissioner and the French Language Services Commissioner while moving their duties to the offices of the Integrity Commissioner and the Ombudsman, respectively.

[33] Bill 213, titled the Better for People, Smarter for Business Act, 2020 was adopted to repeal the Ontario Highway Transport Board Act, grant university status and rename several Christian colleges, remove residency requirements for corporate directors, and allow the Ministry of the Environment to levy new fees for providing documents.

Bill 215 removes local government ability to regulate noise associated with the delivery of goods, and increases fines for unlicenced ridesharing.

Bill 229 reduces the authority of conservation authorities and allows municipalities to opt out;[34] removes promotion of renewable energy generation from the list of objectives of the Ontario Energy Board; exempts Army, Navy and Air Force Veterans in Canada from paying property tax; creates the "seniors' home safety tax credit"; creates iGaming as a subsidiary of the Ontario Lottery and Gaming Corporation; creates the Ontario Centres of Excellence Inc.; exempts forestry operations on crown land from complying with the Endangered Species Act; updates and modernizes the Credit Unions and Caisses Populaires Act; repeals and replaces the Film Classification Act with the new Film Content Information Act; and repeals the Financial Services Commission of Ontario Act.

Bills 254 and 307 brought social media accounts under the purview of the Members' Integrity Act and invoked the "notwithstanding clause" to double the amount of time spending limits are imposed on political advertising by third parties.