The contest was won by Cheslie Kryst of North Carolina, who was crowned by Sarah Rose Summers of Nebraska.

This was North Carolina's third time winning the Miss USA title, and its first in ten years.

[3] Kryst represented the United States at Miss Universe 2019, placing in the top ten.

[7] On March 28, 2019, the Miss Universe Organization (MUO) confirmed that the pageant would be held on May 2 at the Grand Sierra Resort in Reno, Nevada.

The plan was rejected by Hawaiian officials and relocated to Reno by the MUO after the Hawaii Tourism Authority (HTA) reported that they would be unable to secure the funds to host the competition that the MUO had requested, adding that they would be interested in hosting in the future.