In 1821, the Synod of the Presbyterian Church of Nova Scotia granted permission for the formation of the Presbytery of Prince Edward Island. In October of that year, the following men met at the home of Archibald Campbell, Lot 16, and constituted the first Presbytery: Rev. John Keir, moderator; Rev. Robert Douglass and Rev. William MacGregor, ministers; and Edward Ramsay, ruling elder.

As the ruling body of Presbyterian churches on PEI, the Presbytery discussed various issues of interest to the church. With Church Union in 1925, the sphere of influence of the PEI Presbytery came to include churches of the Methodist and Bible Christian traditions as well.

Today, the PEI Presbytery covers twenty-four pastoral charges in the province: Alberton/Elmsdale, Bedeque, Bedeque North, Bideford, Cavendish/Breadalbane, Central Kings, Park Royal, Spring Park, Trinity, Cornwall, Hunter River, Kensington, Margate, Montague, Mount Stewart/Morell/St. Peter’s Bay, Murray Harbour/Murray River, O’Leary/West Cape, Souris/Bay Fortune, Trinity, Tryon/Hampton, St. Andrew’s, Wellington, Winsloe, and York/Covehead.