MD 279 functions as a northern bypass of Elkton and is the primary highway to Newark, Delaware, from Maryland.

The highway becomes a four-lane divided Elkton Road at its intersection with the northern terminus of MD 268 (North Street), after which the route crosses Big Elk Creek, leaves the town limits of Elkton, and immediately meets the southern terminus of MD 316 (Appleton Road).

The state highway heads into a business area and intersects Belle Hill Road, which provides access to a park and ride lot to the east of the road, before meeting I-95 (John F. Kennedy Memorial Highway) at a cloverleaf interchange and crossing Persimmon Run.

Work on the 14-foot-wide (4.3 m) macadam road from the Elkton town limits at Big Elk Creek to the Delaware state line was underway by 1911 and completed in 1915.

[7][8] By this point, the road was part of the Capitol Trail, connecting Atlanta and Philadelphia via Washington, D.C.[9][10] The North Street bridge across the Pennsylvania Railroad (now Amtrak's Northeast Corridor) was constructed between 1930 and 1934.

[11][12] The split segments of North Street leading to the former grade crossing of the railroad were later designated sections of MD 727.

[13] MD 279's present course between Big Elk Creek and Belle Hill Road was constructed and in 1959 and 1960 and surfaced with bituminous concrete in 1962.