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Updated to match(es) played on May 1991. Source: Yedioth Ahronoth (in Hebrew)
Promotion/relegation play-offs
The two second-placed clubs (Hapoel Kiryat Shmona and Beitar Ramla) played off to face the 14th-placed club from Liga Artzit (Hapoel Ashdod). Hapoel Kiryat Shmona won the first match, but lost to Hapoel Ashdod in the second round, so Hapoel Ashdod remained in Liga Artzit and Kiryat Shmona remained in Liga Alef.