Pearl City earned its ninth Hawaii state championship in the major baseball division by defeating Aiea 4-0 in the 2003 Hawaii state championship game at Aiea Annex Field on Oahu.

The win was Pearl City's fourth of the tournament, and second over the tournament host. Pearl City defeated Aiea 6-2 in the winner's bracket finals before Aiea rebounded with a 6-3 win over Hilo National. Aiea capitalized on three Hilo errors and rode the complete game effort of Reyn Nagamire to earn the rematch.

Pearl City had also defeated Hilo earlier in the tournament, rallying for a 4-3 extra inning win despite being held hitless. Hilo pitchers Richie Chinen and Russell Kackley held Pearl City in check and took a 3-0 lead into the sixth inning, but Pearl City rallied for three runs on two passed balls and an error. Two innings later, Pearl City was still hitless, but a bases-loaded walk plated the winning run and moved Pearl City into its first matchup with Aiea.

The Pearl City-Aiea matchup in the winner's bracket finals guaranteed that at least one of the two leagues would reach the championship game for the fourteenth time in sixteen years. Pearl City and Aiea came into the tournament with a combined 54 district championships, 25 state championship game appearances, and 11 state titles. Despite both league's extended run of success, they had met in the title game on only three prior occasions. Pearl City's Little League World Series qualifier in 1988 edged Aiea in extra innings, while Aiea's 1993 and 1995 state champions both went on to finish third in the Western Region tournament.

Pearl City's 2003 squad also finished strongly. At the Northwest Region tournament in San Bernardino, California, Pearl City won five consecutive games before falling 4-0 to Richland National (Washington) Little League in the region championship game.