The Order of St John is fortunate to have very close connections with the Royal Family. His Majesty The King is the Sovereign Head of the Order of St John, having succeeded Her late Majesty, Queen Elizabeth II, who held the role for the duration of her reign.

HRH The Duke of Gloucester serves as Grand Prior, who oversees the work of the Order on behalf of the Sovereign Head. The Grand Prior last visited the Commandery in October 2021 to install the current Knight Commander in St Anne's Cathedral, Belfast, and undertake a Commandery Investiture.

HRH The Princess Royal also has a strong connection with the Order and serves as Commandant-in-Chief (Youth). In July 2022, HRH visited Ballymena Showground to attend a St John Ambulance NI Youth Centenary Event, she was received by the Knight Commander, in his capacity as Lord-Lieutenant of County Antrim. 2022 marked the centenary of St John's work with young people. During the visit HRH met volunteers from the Badgers and Cadets, including the Commandery's Cadet of the Year 2022, William Somerville from Carrickfergus; presented 11 Grand Prior's Awards to young people; and met the Trustees and Executive Team of St John Ambulance NI.

In addition, HRH The Duchess of Edinburgh has been Grand President of St John Ambulance since 2004.