It travels northeast from this point, crossing over and briefly paralleling the Mohawk River as it enters the town of Marcy.

Just north of River Road, NY 291 meets the aforementioned expressway at a partial cloverleaf interchange.

[3] In Marcy, NY 291 intersects Fox Road and provides access to the Marcy Correctional Facility and Mid-State Correctional Facility, both located just west of NY 291.

Outside of Marcy, the route heads through less developed areas of the town as it heads generally northward along Ninemile Creek toward the hamlet of Stittville, a small hamlet on the eastern bank of the creek.

NY 291 heads north through Stittville and crosses over Ninemile Creek, passing through another rural area before ending at a junction with NY 365 about one mile (1.6 km) southwest of the village of Holland Patent.

[3] In 1908, the New York State Legislature created Route 25, an unsigned legislative route that began at Whitesboro and passed through Marcy, Holland Patent and Barneveld before traversing Adirondack Park on its way to Albany.

The portion of Route 25 between the western village line of Whitesboro and Careys Corners was also part of Route 28, which went from Maple View to Utica via Rome, Marcy, and Whitesboro.