The PCA affirms unconditional election and reprobation as taught in the Westminster Confession of Faith III. Before the foundation of the world, God predestined some to everlasting life and others to eternal condemnation. This predestination is based on God's free, sovereign good pleasure, not on foreseen faith or works.

Within the PCA, there is ongoing scholarly debate between supralapsarians (who hold that reprobation is logically prior to the fall) and infralapsarians (who hold that reprobation is conditioned on the reality of sin). Both positions affirm God's sovereign determination and reject Arminian conditional election.

Predestination is not presented as fatalistic but as compatible with genuine human agency and responsibility. God's decree encompasses not only the end (salvation or damnation) but the means (faith, obedience, or resistance). The doctrine is grounded in God's absolute sovereignty and foreknowledge and is intended to assure believers of their secure election.