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2019: Fourth French-US title double, Davis Cup, and year-end No. 1

Nadal was due to start his season at the Brisbane International, but withdrew shortly before due to an injury. He was seeded second at the 2019 Australian Open, where he progressed to his fifth Australian Open final, and did so without losing a set. Nadal then lost in straight sets to Novak Djokovic, winning only eight games for the match and marking Nadal's first straight-sets defeat in a major final. Nadal next played at the Mexico Open, where he lost to Nick Kyrgios in the second round despite holding three match points. He withdrew from both Indian Wells and Miami due to a right hip injury.

Rafael Nadal began the clay season at the Monte Carlo Masters, reaching the semi-finals, where he was upset by Fabio Fognini in straight sets. He then competed in Barcelona, reaching the semi-finals where he lost to Dominic Thiem in straight sets. In Madrid, he reached his third clay-court semi-final of the year, but lost to Stefanos Tsitsipas in three sets. He won his first tournament of the year in Rome, with a three-set win over Djokovic in the final.

At the 2019 French Open, Nadal defeated Kei Nishikori and Roger Federer (their first meeting at the tournament since 2011) en route to the final, dropping only one set en route. In a rematch of the previous year's final, Nadal prevailed in four sets against Thiem to claim his record-extending twelfth French Open title. In doing so, he broke Margaret Court's all-time record of singles titles won at the same major.

Nadal next played at Wimbledon and, like the previous year, reached the semi-finals, where he faced Federer for the first time at Wimbledon since the 2008 final. Nadal lost the match in four sets. At the Rogers Cup, Nadal was the defending champion and top seed. By defeating Fabio Fognini in the quarterfinals, he surpassed Roger Federer's record of 378 victories at Masters tournaments. In the final, Nadal yielded just three games to Daniil Medvedev, winning in straight sets. This victory marked the first time he defended a title on a surface other than clay. At the US Open, Nadal lost only one set (against Marin Čilić) en route to the final, where he won against Medvedev in five sets. In doing so, Nadal claimed his fourth US Open title and 19th major title overall (placing him only one behind Roger Federer in overall standings), and completed his second-best season in terms of Grand Slam singles results. At the Paris Masters, Nadal reached the semi-finals, but withdrew due to an abdominal injury.

At the ATP Finals, Nadal defeated Tsitsipas and Medvedev in the round-robin stage, but failed to progress to the semi-finals. Despite his elimination, Nadal secured the year-end No. 1 ranking when Djokovic was also eliminated in the round-robin stage. This was Nadal's fifth time as the year-end No. 1 player, drawing level with Jimmy Connors, Federer and Djokovic behind Pete Sampras (six), and in doing so, he surpassed a number of the records he set in 2017, becoming (at the time) the oldest person to finish as the year-end No. 1 player, and creating a record eleven-year gap between his first and last year-end No. 1 seasons (2008 and 2019, respectively).

At the 2019 Davis Cup Finals, Nadal helped Spain win its sixth Davis Cup title, defeating Canada in the final. Nadal won all eight of his matches in singles and doubles, extending his winning streak in Davis Cup singles matches to 29 (29–1 record overall), without dropping a set or having his serve broken; he also won the tournament's Most Valuable Player award.