In 1861, Presbyterians in the Southern United States split from the denomination because of disputes over slavery, politics, and theology precipitated by the American Civil War. They established the Presbyterian Church in the United States, often called the "Southern Presbyterian Church".

Presbyterians distinguish themselves from other denominations by doctrine, institutional organisation (or "church order") and worship; often using a "Book of Order" to regulate common practice and order. The origins of the Presbyterian churches are in Calvinism.

Most of the Reformed confessions of the Presbyterian tradition reflect a doctrine of predestination as a part of justification by grace; some are more explicit than others.

Those who trust in Christ alone for the forgiveness of their sins, and repent, are accepted by God and will go to heaven. No one can be saved in any other way. The Holy Spirit. Only the Holy Spirit can bring people to faith and repentance, which He does when He regenerates them into spiritual life.