Before you start

A valid foreign driving licence
Regularised residence in North Macedonia
A certified Macedonian translation of the licence
The standard medical certificate the Ministry requires for licence issue

Step-by-step

1
Check whether your country is on the Ministry's recognition list
North Macedonia has bilateral licence agreements with Albania, Bosnia and Herzegovina, Germany, Italy, Kosovo, Serbia, Montenegro and Spain, and exchanges on the basis of national law and the Vienna Convention with Czechia, Bulgaria, Croatia, Slovenia, Romania, Hungary, Belgium, Poland, and — category B only — Austria, Denmark and the United Kingdom. Greece does not exchange licences with North Macedonia in either direction.
OnlineWho: You
2
Get the licence translated and certified
An original valid foreign licence with a Macedonian translation by a court-appointed translator, notarised. This is the step people forget and the one that sends you home from the counter.
In personWho: You
3
File the exchange application at a Ministry of Interior counter
The Ministry publishes the form 'Барање за заменување на дозволата издадена од надлежен орган на друга држава' — request to replace a licence issued by the competent authority of another state — in its civil-procedures section. Appointments for personal documents are booked through the Ministry's termin.mvr.gov.mk system.
In personWho: You
4
Pay the fee
MKD 410 for the form plus MKD 110 administrative tax in the regular procedure — MKD 520. The expedited procedure is MKD 1,230 plus MKD 110, i.e. MKD 1,340.
In personWho: YouMKD 520 regular / MKD 1,340 expedited
5
Register a vehicle if you brought one
The registration document (сообраќајна дозвола) is MKD 200 plus MKD 110 tax; the registration sticker MKD 60; plates MKD 1,200 plus MKD 50 tax. The Ministry lists a specific plate category for vehicles owned by foreigners holding temporary or permanent residence.
In personWho: YouMKD 310 for the registration document; MKD 1,250 for plates

Documents you’ll need

Original valid foreign driving licence
Notarised Macedonian translation of the licence
Passport and residence permit
Medical certificate for licence issue
Completed exchange application form
Payment slips for the form fee and the administrative tax

Things most newcomers don’t know

The Ministry publishes exactly where its Skopje traffic police put the speed cameras.

The list names Bul. Koco Racin, Bul. Goce Delčev, Bul. Nikola Karev, Bul. Srbija, Ul. Prvomajska, Bul. III Makedonska Brigada, Bul. Jane Sandanski, Bul. Partizanski Odredi, Bul. Oktomvriska Revolucija, Ul. Ivo Lola Ribar, Bul. Ilinden and Ul. Adolf Ciborovski — plus the Diamant interchange and the Alkaloid entrance in Gazi Baba. Published, not leaked.

Source: Ministry of Interior

The Italian arrangement is currently one-way.

The Ministry notes that exchange into an Italian licence is not presently possible, while licences issued under the old 'Republic of Macedonia' name continue to be exchanged, and that the situation is being worked on. A live example of why you check the list rather than assume the treaty.

Source: Ministry of Interior

Skopje's real driving problem is parking and the river crossings, not the rules.

The city is split by the Vardar with a small number of bridges, and central on-street parking is zoned and enforced. Most people who live inside the ring end up not using a car for the commute at all — the bus, a scooter or walking beats the Bul. Partizanski Odredi queue at 08:30.

Source: community-reported

Common mistakes to avoid

Turning up without the notarised Macedonian translation. The Ministry's own request form is for a licence 'issued by the competent authority of another state' — proving what it says is your job.
Assuming Greece is covered because it is next door. It is the one neighbour that does not exchange, in either direction.
Reading the Ministry's country list as an inbound list only. It is a reciprocity list, so the same page tells you what happens to your Macedonian licence if you move on.
Paying the expedited MKD 1,340 without needing to. The regular procedure is MKD 520 and the difference is only turnaround.
Confirm at the counter whether your licence exchanges without re-sitting the driving exam. The Ministry publishes the fee and the recognition list but not a consolidated statement of the test requirement, and the answer depends on which of the two lists — bilateral agreement or Vienna Convention recognition — your country sits on.

Some of this may be out of date. Spotted something inaccurate? Help us keep it right for the next newcomer.