In 2019–20, the competition will be divided into five divisions named Third League - North (Трета Лига - Север), Third League - Center (Трета Лига - Центар), Third League - Southeast (Трета Лига - Југоисток), Third League - West (Трета Лига - Запад) and Third League - Southwest (Трета Лига-Југозапад). At the end of the season, the winners of the North, West and Southwest divisions will be play in a play-off for promotion to the Macedonian Second League, while the winners of Center and Southeast divisions will be directly promoted to the Second League. The bottom teams from all divisions are relegated to the Macedonian Municipal Leagues.
Winners
Key
†
Club gained promotion to the unified Second League
1. a : Metalurg Veles was withdraw from the Second League days before the start of the season, their place was taken by Lozar.[1]
2. a : Lokomotiva was promoted after the win in the additional play-off match against Korabi because was the Second League expanded after the play-off chaos.[2]
3. a : Babi was promoted because Bregalnica Delchevo was rejected the promotion.
4. a : Shkupi was lost promotion play-offs, but due to the merger with Korzo the club was promoted.
5. a : Vëllazërimi was lost promotion play-offs, but due to the merger with Vrapčište the club was promoted.
6. a : Novaci was lost promotion play-offs, but due to the withdrawal of Mladost Carev Dvor from the Second League the club was promoted.[3]
7. a : Tikvesh was promoted due to the withdrawal of Ljubanci from the Second League.