Known as Sixth Street, the state highway runs 1.09 miles (1.75 km) from an intersection with 5th Avenue north to an interchange with MD 313 and MD 404 within the town of Denton in central Caroline County.

MD 619 begins at an intersection with 5th Avenue on the south side of Denton.

The state highway heads north on two-lane undivided Sixth Street through a residential area.

East of the downtown area, MD 619 meets MD 404 Business, which follows a one-way pair on eastbound Franklin Street and westbound Gay Street.

5th Avenue continues south as a municipal street that serves a few residences and a shopping center before ending at Sharp Road.