The Serbian clubs (Partizan, Crvena zvezda, Radnički and Vojvodina) joined the league in the 2014–15 season.

[2] In February 2019, three team members of Serbian club Crvena zvezda were attacked in Split by Croatian ultra-nationalists, before regional league game against Mornar.

[4] Following the incident, the Water Polo Federation of Serbia and Serbian clubs in competition sought to not play any further games in Split, and competition's Board of Directors made a decision to postpone any further games in Split in which Serbian clubs are included.

In 2021–22 season, the newcomer to the competition, Novi Beograd, lifted its maiden trophy.

A total of 22 clubs from five countries have played in the top-tier of the Regional League.