Voters will elect a new president in a run-off vote dominated by deep divisions over a change in the country's name agreed with Greece that has opened the path to NATO and EU membership.
Voting in a run-off for a new president in North Macedonia began on Sunday, in an election that has been dominated by divisions over a change in the country's name to mollify Greece and open the way for membership of NATO and the European Union.
Zizi Markovic, 74, was the first to vote in a polling station in Skopje's Kole Nedelkovski school when it opened at 7 am (0500 GMT).
"I am proud to have been the first voter. I expect that after this election North Macedonia will move faster towards the EU and NATO (membership)," she told Reuters news agency after casting her ballot.
Greece had for decades demanded that the tiny ex-Yugoslav republic change its name from Macedonia, arguing that it implied a territorial claim on a northern Greek province also calledMacedonia. The new name was formally ratified earlier this year.
But the accord continues to divide Macedonians and has eclipsed all other issues during campaigning for the presidential election, when about 1.8 million eligible voters will choose between two candidates who got through to the second round.
The centre-left ruling party's Stevo Pendarovski and the right-wing pick Gordana Siljanovska-Davkova finished in a dead heat in the first round of voting last month.
The tie traced the near-even split between the pro-Western and nationalist camps who have clashed over the government's recent move to change the Balkan country's name to North Macedonia which ended a long-running row with Greece.
But a record-low turnout, at barely over 40 percent, also reflected a failure to galvanise most of the voters.
If voter participation sinks below 40 percent in Sunday's second-round runoff, the entire poll will be annulled, threatening a new period of political uncertainty in one of Europe's poorest states.
More than 3,000 domestic and about 420 international observers will monitor the poll.
'Elections will succeed'
Prime Minister Zoran Zaev is confident "the elections will succeed". But if not, he said he would call a snap poll for parliament.
The presidential vote would also likely be re-run from the start, though Zaev has floated other options involving constitutional changes.
The presidency is a largely ceremonial role but the office can exercise veto powers that complicate governing.
The current president, opposition-backed Gjorge Ivanov, has been refusing to sign bills since the country changed its name to North Macedonia in protest against the deal.
The small, landlocked state has weathered repeated bouts of political turmoil in recent years, with nearly 10 elections in the past decade doing little to boost the public's faith in politicians.
Turnout on Sunday will be a "challenge" in light of "election fatigue and low voter enthusiasm", said David Stephenson, a political consultant based in Skopje.
But he said the tight first round could spark more energy for the run-off.
"What's important is to elect a president in a free, fair, and democratic process," he added.
"Failure to do so risks another period of political instability, which would likely harm the country's European perspective and damage economic growth."
Zaev said he would also call an early general election in the event of a loss by 56-year-old Pendarovski, who is championing efforts to forge closer links with the West.
A victory by Siljanovska-Davkova, 63, would be a clear rebuke to a government that staked its reputation on passing the name accord with Greece earlier this year.
The addition of "North" to the country's name was a compromise to end a nearly 30-year identity row with Athens that had blocked Skopje's NATO and EU ambitions.
It remains a divisive topic and a key talking point for the presidential candidates, with Pendarovski for the deal and Siljanovska-Davkova against.
Macedonia's ethnic Albanian minority, which makes up around a quarter of the population, could prove decisive on Sunday.
Their presidential candidate dropped out of the race after garnering 11 percent in the first round.
The candidate, Blerim Reka, has not publicly backed either of the two frontrunners by name.
But he has urged Albanians to vote for the "pro-Western agenda", in what is seen as thinly-veiled support for Pendarovski.
The polls will close at 1700 GMT.