Mixed fortunes as Sunderland survive, but Middlesbrough and Newcastle go down to the Championship
After a nightmare season for all the Premier League clubs in the north east, Newcastle and Middlesbrough finally slipped out of the trapdoor and into Championship football next season.
BBC Sport looks at what next season will bring for the north-east clubs involved in the last-day drama.
SUNDERLAND - 16TH PLACE - SAFE
Sbragia steps down at Sunderland
Sunderland are no strangers to relegation from the Premier League, it is only four seasons since they suffered the fate themselves.
However, they stayed up courtesy of defeats for Hull City and Newcastle and will have their top-flight status intact next season.
What they will not have is a manager - not at this stage - after Ricky Sbragia stepped down only moments after safety was secured.
There have been plenty of names linked with the post already, including Celtic manager Gordon Strachan, and chairman Niall Quinn conceded that a boss with a bigger profile than Sbragia is necessary to guide the club forward.
It is likely that the club's playing staff will also undergo a transformation - millions of pounds were spent on players last summer to little success.
Players such as El-Hadji Diouf and Pascal Chimbonda remained at the club for a matter of months before departing, while loanee Djibril Cisse is unlikely to find a contract in his pigeonhole after a miserable last few months on Wearside.
More is expected next season on the field and in the transfer market.
TV income: Approx £45m
NEWCASTLE - 18TH PLACE - RELEGATED
Tears on the Tyne as Newcastle are relegated
Newcastle United drop out of the Premier League after 16 seasons, after a 1-0 defeat by Aston Villa at Villa Park.
The Magpies have been in the Premier League for all but one season since its inception in 1992, and now face a challenge to return there within as short a space of time as possible.
Like Sunderland, there is uncertainty over the position of their manager - Alan Shearer accepted the role on a temporary basis back in April and remained distinctly undecided about his future after Sunday's game.
"I'm angry at the whole situation. You can say I haven't been good enough, the players, the managers before that," he told BBC Sport
"There are huge things that have gone on that haven't been right - and now we're paying the price. You've seen our magnificent fans and what they deserve - they deserve better than what they've had probably for the last five or six seasons."
The future of the club's highly paid, and in some cases underplayed stars is also in question.
Michael Owen, Joey Barton, Nicky Butt and Kevin Nolan are only four of the big-earners who face being sold.
And investment will be needed to resurrect a side that will be hoping to bounce back at the first attempt.
TV income: £1m-per-season
Parachute payment: £11m for the first two seasons
MIDDLESBROUGH - 19TH PLACE - RELEGATED
Relegation is a 'hard lesson' - Southgate
During the 1990s, Middlesbrough were a yo-yo club, flitting between the top two divisions intermittently.
An 11-year period of stability was then achieved before relegation from the Premier League was confirmed by the defeat at West Ham on Sunday.
Manager Gareth Southgate took Boro to a Uefa Cup final as a player under Steve McClaren but as a manager the club has struggled with two bottom-half finishes and, latterly, a relegation.
Chairman Steve Gibson seems determined to keep faith with the 38-year-old in the Championship and with a relatively young squad without a great number of high-earners, there can be some optimism within the club.
However, big name players such as Stewart Downing, Robert Huth and particularly Tuncay, who has served the club with pride since joining from Fenerbahce two seasons ago, are almost certain to leave.
Their departures will leave big gaps, whether Southgate has the transfer nous to bring in the right replacements will be a key factor in the club's response to relegation.
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