The state highway heads south as two-lane undivided Main Street into the town limits, passing to the southwest of the historic home Bishopton and intersecting MD 300 (Sudlersville Road).

The highway passes south of the historic Churchill Theatre-Community Building, exits the town, and crosses Southeast Creek.

MD 19's name remains Walnut Street until its intersection with the northern terminus of MD 405 (Price Station Road), where the route continues southeast on Roberts Station Road.

[3] The entire road from Main Street in Church Hill to Ingleside was built in 1915 with a width of 14 feet (4.3 m).

[8] MD 19 was then extended over US 213 to its current western terminus after US 213's bypass of Church Hill was completed in 1970.