On January 27, 2019, at the Royal Rumble event, Jax competed in the women's Royal Rumble match, entering at number 29 and lasting for over 11 minutes before she herself was eliminated by the eventual winner Becky Lynch. Later that night, Jax made history as she became the first person to ever compete in two Royal Rumble matches on the same night and the fourth woman to ever compete in a men's Royal Rumble match, after she attacked R-Truth and took his number 30 spot. Despite eliminating Mustafa Ali, Jax was ganged up by Dolph Ziggler, Rey Mysterio and Randy Orton with their finishers, before being eliminated by Mysterio. On February 17, 2019, Jax and Tamina competed in a six-team Elimination Chamber match at the namesake pay-per-view to determine the inaugural holders of the WWE Women's Tag Team Championship, where they eliminated two teams before they themselves were eliminated. In April, at WrestleMania 35, Jax and Tamina took part of a fatal four-way match for the Women's Tag Team Championship, however, the match was won by The IIconics (Billie Kay and Peyton Royce). Shortly after, Jax underwent surgery to repair tears on the anterior cruciate ligament (ACL) in both of her knees, which was expected to sideline her from in-ring competition for at least nine months.