In Massachusetts, the road is town-maintained except for the bridge approach, which is state-maintained.

Route 168 begins at U.S. Route 202/Route 10 in Southwick, within the area known as the Congamond Notch (or Southwick Jog), site of a boundary dispute between Massachusetts and Connecticut.

It crosses over Congamond Lake on a short bridge, at the east end of which it crosses the Connecticut state line into the town of Suffield.

[1] Route 168 was originally part of the original alignment of Route 190 when that road was created as part of the 1932 state highway renumbering.

In 1975, Interstate 190 was formally assigned to a proposed expressway in Worcester, Massachusetts, which created a numbering conflict with Route 190.