Due to the setup of the junction, the northbound and southbound roadways, both two lanes wide, are initially set about 250 yards (229 m) apart.

The expressway proceeds north through neighborhoods equally residential and industrial, crossing over both the former right-of-way of the CSX Transportation-owned Falls Road Secondary Track and the Erie Canal prior to meeting Lexington Avenue via a modified trumpet interchange.

[4] Past NY 104, the roadway surface shifts from pavement to concrete as the freeway heads generally northward through primarily residential neighborhoods.

[6] The next exit, with Vintage Lane 1.5 miles (2.4 km) to the north-northeast of NY 104, is the highway's last as a six-lane freeway.

At this point, all commercial vehicles are forced to exit NY 390 due to a similar restriction on the Lake Ontario State Parkway 1 mile (1.6 km) to the north.

[7][8] It was originally designated as part of NY 47, which had followed the parallel Howard Road to the west prior to the freeway's construction.

[12][13] The freeway officially became part of NY 47 on January 1, 1970, when the route was extended northward over the then-proposed Outer Loop to a new terminus at the Lake Ontario State Parkway.

As Greece and towns on the northwest side of Rochester have expanded, NY-390 emerged as the primary highway link southward.

The interchange of NY/I-390 and I-490 currently serves over 200,000 cars daily — compared to 25,000 when it was designed and opened in the 1960s — and regularly has heavy congestion during the morning and evening rush hours.