SR 159 was original signed in 1923, on much of its current alignment.

[6][7] In 1935 the second section was paved between Meade and Tarlton.

[8][9] The final section of the roadway was paved between Tarlton and the northern terminus, in 1938.

[12][13] In 1972 the highway was extended south to its current terminus along the former alignment of U.S. Route 23.

[13][14] A construction project in Ross County added two roundabouts at a new intersection with SR 207 and the intersection of SR 180.