NY 19 does not serve any major cities or metropolitan areas and remains a two-lane rural road for almost its entire length.

However, it follows the Genesee River for much of its lower length, and offers easy access to the gorges of Letchworth State Park midway along its route.

Most of modern NY 19 between Wellsville and Le Roy was originally designated as part of a legislative route in 1908.

Much of this stretch was included in Route 16, an unsigned highway that initially extended from Cuba to Le Roy via Belfast.

Just south of the first New York community it encounters, the hamlet of Shongo in the Town of Willing, it crosses the river.

[citation needed] After Stannards, NY 19 crosses Chenunda Creek as the Genesee Valley widens somewhat, and continues north to the village of Wellsville, the largest community in Allegany County.

North of Wellsville, the NY 19 corridor remains fairly well-developed as the highway makes its way to the smaller village of Belmont, the county seat.

Again the intersecting state highway is displaced to the north of the village, where NY 78 heads off to the west despite being signed as a north–south route.

[citation needed] The route heads northeast from Gainesville to the hamlet of Rock Glen outside of Silver Springs, where NY 19A returns to its parent route and NY 19 passes under the Norfolk Southern Railway-owned Southern Tier Line.

It begins this new course while running through the Wyoming Valley, formed by Oatka Creek, a tributary of the Genesee River.

At the Middlebury–Covington town line, NY 19 takes a sudden right turn from its route to follow Schwytzer–East Bethany Road for 3 miles (4.8 km) to Silver Lake Road, where it once again assumes a due north heading as it begins to parallel the Rochester and Southern Railroad and enters Genesee County.

The similarly named but smaller Pavilion Center 2 miles (3.2 km) to the north marks the junction—a pseudo-parclo interchange—with US 20.

After passing the historic buildings of Lake Street, it crosses the CSX Transportation-owned Rochester Subdivision before exiting the village limits.

Several miles (kilometers) later, after passing the Bergen Swamp Wildlife Refuge and crossing over Black Creek, it crosses its last county line, entering the rural southwestern corner of Monroe County.

The route heads north through the lightly populated town of Sweden to a large commercial district located a short distance south of the southern boundary of Brockport, the largest community on NY 19's entire length.

A few miles (kilometers) more brings the route to North Hamlin and finally its northern terminus at the Lake Ontario State Parkway.

Under the terms of the act, it took effect 90 days after it was signed into law; thus, the maintenance swap officially took place on November 26, 2007.

In the early 1980s, NY 31 was rerouted to bypass Brockport on Redman and Fourth Section roads.

Under the terms of the act, it took effect 90 days after it was signed into law; thus, the maintenance swap officially took place on November 26, 2007.