The Model 119 was designed in 1957 for the U.S. Air Force's UCX (Utility-Cargo Experimental) contract announced in August 1956, competing with the Lockheed JetStar.

The cabin floor had tracks to allow interior fitments to be changed quickly to suit different missions; the aircraft could be used for medical evacuation, with room for 12 stretchers and two attendants, and McDonnell also promoted it as a trainer for bombardiers, flight navigators, radar operators, or electronic countermeasure technicians.

Fitted with Westinghouse J34 turbojets for flight test purposes, the 119 was first flown on 11 February 1959, but the Air Force rejected it later that year in favor of the Lockheed JetStar (designated C-140), citing concerns about foreign object damage with the 119's low-mounted engines.

McDonnell drew up plans to equip production models with more modern Pratt & Whitney JT12 or General Electric CF700 engines, and the 220 was awarded a Federal Aviation Administration (FAA) type certificate on 17 October 1960.

The McDonnell Corporation subsequently used the prototype as a VIP transport before selling it in March 1965 to the Flight Safety Foundation, which used it for crash survival tests and other research in Phoenix, Arizona.