The name change is an effort to overcome a 27-year-old argument with neighbouring Greece, which has refused to recognise Macedonia's name since the Balkan country declared independence from Yugoslavia in 1991.
Polls have opened in Macedonia's crucial referendum, where citizens are deciding whether to accept a landmark deal ending a decades-old dispute with neighbouring Greece by changing their country's name to Republic of North Macedonia, paving the way to NATO and EU memberships.
Macedonians were deciding Sunday whether they were "in favour of membership in NATO and European Union by accepting the deal between (the) Republic of Macedonia and Republic of Greece."
It is a loaded question for many in the nation of around 2.1 million, which has tussled with Greece for 27 years over its name and history.
Athens objects to its northern neighbour's name because it has its own province called Macedonia.
It accuses Skopje of encroaching on its territory and cultural heritage.
TRT World's Iolo Ap Dafydd reports.
In protest Greece has used its veto to thwart Macedonia's progress in NATO and EU accession talks.
But in June the two neighbours reached a compromise: the Republic of North Macedonia.
Now Macedonians are being called on to approve the name, despite a widespread feeling that they have been pushed around by Greece.
Prime Minister Zoran Zaev is selling the name-change as a once-in-a-lifetime opportunity for the poor country to move past the row and integrate with the West.
He has the backing of a host of European and US leaders who have trotted through Skopje this month to shore up support.
"You know well that a better deal cannot be made," Zaev told a crowd this week in one of his final campaign events.
Some Macedonians say they are willing to vote "yes" in the hope that NATO and EU membership will inject life into a flat economy ravaged by emigration.
"We won't ever have a chance for a better future for Macedonia," said Bogdana Zabrcanec, a resident of the central city of Prilep who came to listen to Zaev speak this week.
But even if voters approve the name change, the deal will still need to be ratified in parliament, where a right-wing opposition threatens to block it.
Zaev is hoping a strong majority for "yes" will make it difficult for the nationalist VMRO-DPMNE party to resist the public's will.
But turnout figures could prove contentious.
If less than half of the 1.8 million registered voters cast ballots, detractors may attack the referendum's credibility.
That turnout figure could be hard to reach in a country where a quarter of the population is estimated to have emigrated abroad.
So far, the boycott movement has been mostly limited to online activities. A planned rally on Thursday night was cancelled, with only several dozen people showing up.
The opposition's leader, Hristijan Mickoski, said this week that Macedonians should "listen to their heart" when they wake up on Sunday morning.
Meanwhile, president Gjorge Ivanov, who is allied with the nationalist opposition, told the UN assembly this week that he personally would not vote, describing the deal as "historical suicide".
A failure to pass the referendum could crush a rare diplomatic breakthrough in the Western Balkans, a region riven by complex disagreements between neighbours.
The name deal "was a really positive story... It's been held as a sign that look, longstanding disputes can be solved," James Ker-Lindsay, a Balkans specialist at the London School of Economics.
But "this is just the next phase in what is proving to be quite a long protracted process," he added, explaining that the parliament vote will be the next hurdle.
While NATO's invite is waiting on the table, the road to EU membership is less sure.
By EU standards, Macedonia still has a lot of work to do to tackle graft and the rule of law.
And the appetite for EU enlargement is shrinking among some members of the bloc, who voted to postpone Macedonia's accession talks to next year despite the deal.
Polling stations will be open from 0500 to 1700 GMT with 500 foreign observers monitoring, according to Telma TV channel.