Outside of Little Falls, NY 169 is a two-lane highway that passes through sparsely developed areas.

It initially heads northward, paralleling a north–south roadway leading away from the exit that overpasses NY 5S.

[3] As the route approaches Little Falls, it makes a slight turn to the north, crossing over the Mohawk River (here part of the Erie Canal) and the CSX Railroad, on its way to an intersection with a divided highway carrying NY 5 and NY 167.

[3] The route follows the couplet for three blocks, passing through the city's central business district prior to intersecting Ann Street.

Here, the two directions of NY 169 converge to follow Ann Street north into a more residential neighborhood.

Now in the town of Little Falls, the route passes through mostly open areas while serving a small handful of isolated homes.

It eventually crosses into the town of Fairfield, where it takes on a more northerly and more winding alignment.

[10] On April 9, 2010, the bridge that carries NY 169 over Stoney Creek was closed to traffic, to perform repairs.