For the 2019 event, the winners of both the men's and women's matches received a choice of which championship to challenge for at WrestleMania 35.

In the main event, Raw's Seth Rollins won the men's Royal Rumble match by last eliminating Braun Strowman, also from Raw, while SmackDown's Becky Lynch won the women's Royal Rumble match by lastly eliminating Charlotte Flair, also from SmackDown.

The event also featured the return of Jeff Jarrett, who competed in his first WWE match since No Mercy in October 1999.

[10] At TLC: Tables, Ladders & Chairs, Fabulous Truth (Carmella and R-Truth) defeated Mahalicia (Alicia Fox and Jinder Mahal) to win the second season of Mixed Match Challenge.

[12][13] At Crown Jewel, Brock Lesnar defeated Braun Strowman to regain the then-vacant Universal Championship, thanks in part to then-Acting Raw General Manager Baron Corbin.

Strowman shattered the glass and broke the door off, only for WWE Chairman Vince McMahon to appear, revealing that was his limo.

Later that night, John Cena, Drew McIntyre, Corbin, and Finn Bálor expressed their interests in facing Lesnar at the Royal Rumble.

Mr. McMahon scheduled a fatal four-way match where the winner would face Lesnar, which Bálor won after defending his spot earlier in the night against Jinder Mahal.

[11] On the January 1, 2019, episode of SmackDown, Styles earned another opportunity against Bryan at the Royal Rumble by winning a fatal five-way match.

[16] At TLC, Asuka defeated Becky Lynch and Charlotte Flair in a triple threat Tables, Ladders, and Chairs match to win the SmackDown Women's Championship.

After she, Flair, and Carmella all pleaded their cases for why they deserved a title opportunity on the January 1, 2019, episode of SmackDown, WWE Chief Operating Officer Triple H scheduled a triple threat match between the three for the following week to determine Asuka's challenger at the Royal Rumble,[16] which was won by Lynch.

[18] At Crown Jewel, Shane McMahon won the WWE World Cup, replacing The Miz in the finals, who was deemed unable to compete due to a pre-match brawl.

[17] On the TLC Kickoff pre-show, Buddy Murphy retained the WWE Cruiserweight Championship against Cedric Alexander.

[19] The following week, Kalisto and Akira Tozawa qualified for the match by defeating Lio Rush and Drew Gulak, respectively.

[21] On the December 25, 2018, episode of SmackDown, Rusev defeated Shinsuke Nakamura to win the United States Championship.

[16] On the January 15 episode, Rusev was scheduled to defend the title against Nakamura on the Royal Rumble Kickoff pre-show.

[1] In the second match, The Bar (Cesaro and Sheamus) defended the SmackDown Tag Team Championship against The Miz and Shane McMahon.

During the match, Rousey attempted a forearm on Banks, who moved out of the way, causing it to crash into the ring post.

Rousey tried to make it to the bottom rope, but Banks transitioned into a crucifix pin for a nearfall and applied a "Fujiwara armbar".

Natalya applied a sharpshooter on Evans and Mandy Rose (entrant #3) at the same time before Liv Morgan entered at #4.

Jax would go on to eliminate Shirai, Natalya (who lasted the longest in a women's Royal Rumble match at 56 minutes until it was surpassed by Bianca Belair in 2021), and Bayley (entrant #27).

[1] At one hour and twelve minutes in length, this is the longest women's Royal Rumble match held to date.

As #30 entrant R-Truth made his entrance, he was attacked by Nia Jax, who took his spot and eliminated Mustafa Ali.

After retaining, women's Royal Rumble match winner Becky Lynch made her entrance and confronted Rousey.

After recapping their rivalry that began at Survivor Series, Lynch chose to face Rousey for the Raw Women's Championship at WrestleMania 35.

Triple H then came out and congratulated him, but said that Rollins needed to choose which champion he wanted to face at WrestleMania 35 by the end of the night.

Backstage, Braun Strowman, the runner up in the Royal Rumble match, confronted Rollins and told him he "earned it", and to "make the right decision".

[26] On the following SmackDown, Becky Lynch addressed how everything had changed for her since winning the women's Royal Rumble match.

[27] Daniel Bryan, along with his new ally Rowan, revealed a new custom WWE Championship belt, made from hemp and wood.

He was then interrupted by AJ Styles, which prompted Jeff Hardy, Samoa Joe, Randy Orton, and Mustafa Ali to come out and challenge Bryan for the title.