The field was open to 20 horses, who qualified for the race by earning points on the 2019 Road to the Kentucky Derby.

It is a Grade I stakes race for three-year-old Thoroughbreds at a distance of 1+1⁄4 miles (2.0 km), and has been run at Churchill Downs racetrack since its inception in 1875.

[9][a] The field is limited to twenty horses who qualify based on points earned in the 2019 Road to the Kentucky Derby, a series of designated races that was first introduced in 2013.

[10] Most positions in the Derby starting gate are earned on the main Road, consisting of 34 races in North America plus one in Dubai.

The post position draw took place on April 30, after which Omaha Beach was installed as the 4–1 morning line favorite.

[1] Maximum Security went off as the second favorite (behind Improbable) at odds of 9–2 based on his frontrunning win in the Florida Derby.

In the process, he made contact with War of Will and also interfered with Long Range Toddy and Bodexpress, causing all three horses to check strides.

Saez, who later said that Maximum Security swerved in reaction to noise from the large crowd, quickly corrected course and returned to the two path, bumping Code of Honor who had been gaining ground on the rail.

Although Country House was not materially harmed by Maximum Security's swerve on the far turn, at least three other horses — War of Will, Long Range Toddy, and Bodexpress — were severely affected.

[21] The ruling proved controversial, with Maximum Security's owners blaming jockey Tyler Gaffalione on War of Will for causing the incident.

[22] The stewards later issued a fifteen-day suspension on Maximum Security's jockey, Luis Saez, for "failure to control his mount and make the proper effort to maintain a straight course thereby causing interference with several rivals".

[32] Several horses from the 2019 Derby went on to win Grade I races later in their career, including Maximum Security, who was named the champion three-year-old colt.