Highway 19 is situated entirely in Oxford County and serves the communities of Ostrander, Mount Elgin and Salford.

Prior to 1998, it began in Port Burwell on the shores of Lake Erie, while the northern terminus extended to Highway 86 east of Listowel in the community of Tralee.

[3] The route begins on the southern edge of Tillsonburg at Highway 3 (Talbot Road), travelling north along the eastern side of Big Otter Creek.

At Broadway Street, Highway 19 turns northwest and passes through the downtown strip as well as beside Tillsonburg Town Centre.

It crosses the Ontario Southland Railway, which lies roughly parallel to the entire length of the highway, before passing west of Tillsonburg Airport and curving northwest.

[5] George Tillson, his sons, and his brother-in-law Benjamin Van Norman were the principal stockholders of the Ingersoll and Port Burwell Road Company, which they formed along with approximately 200 shareholders in September 1849.

Proceeding quickly, the company established eight toll booths along the new route, which became known as the Plank and Gravel Road due to the materials with which it was constructed.

Several months later, on July 1, the department assumed the remainder of the Ingersoll to Port Burwell Road, extending Highway 19 south of Tillsonburg.

[7] As part of a depression relief program, the DHO and Department of Labour undertook several projects in 1933 and 1934, one of which included the Stratford to Tralee Road.