A number of managers have called on the top flight to embrace the change, with Jurgen Klopp calling it a “necessity” and Pep Guardiola calling the current three limits “disaster”.
The Premier League is currently the only major league in Europe not to retain the limit of five substitutes introduced when domestic football resumed towards the end of last season.
The proposal had already been rejected twice before the start of the 2020/21 campaign and again failed to reach the threshold of 14 votes in favor at a meeting of the 20 clubs.
However, teams will be allowed to name nine players to the bench, against the previous seven, starting this weekend.
PL clubs approve concussion substitutes
Despite choosing to reject the five-substitute proposal, the Premier League clubs have voted in principle to introduce permanent concussion substitutes.
Teams may use up to two additional substitutes per game if players suspect or are suffering from a concussion.
The move comes after the International Football Association Board (IFAB) – which governs the laws of the game – approved the rule change on a trial basis on Wednesday.
The Premier League will now ask IFAB to take part in the test, which will start next month.
The Football Federation is also in favor of putting in place concussion substitutes and says it will bring them into its competitions “at the first practical opportunity.”