Japan will hold elections next year for the less powerful upper house, where the ruling coalition’s slim majority could also be at risk if Ishiba cannot revive public trust roiled by a scandal over unrecorded donations to lawmakers.
His imminent challenge is compiling a supplementary budget for the fiscal year through March, under pressure from voters and opposition parties to raise spending on welfare and take steps to offset rising prices.
For approval, he needs the backing of at least one opposition party, which is most likely to be the Democratic Party for the People (DPP) headed by Yuichiro Tamaki.
He has held cooperation talks with Ishiba, but DPP lawmakers on Friday did not vote for Ishiba to stay on as prime minister.
Tamaki is also in a precarious position after admitting Monday to an extra-marital affair revealed in a tabloid magazine.
With his premiership confirmed, Ishiba now has to prepare for a slate of international engagements, including a summit of the Group of 20 big economies in Brazil on Nov 18 and Nov 19.
He is also trying to arrange a stopover in the United States on the way to or from that gathering to meet Trump.
Some Japanese officials fear Trump might again hit Tokyo with protectionist trade measures and revive demands for it to pay more for the cost of stationing US forces there.
These issues were largely smoothed over in Trump’s first term, from 2017 to 2021, by the close ties between the president and Japan’s then-premier, Shinzo Abe – a bond Ishiba seems keen to re-establish.