The section of PA 199 between the southern terminus and the intersection of Keystone Avenue and Mohawk Street in Sayre was designated as part of US 711 when the U.S. Highway System was created in 1926, being renumbered to US 220 a year later.

PA 199 begins at an intersection with US 220 in Athens Township, Bradford County, heading east on a two-lane undivided road.

PA 199 curves east and crosses the Chemung River into the borough of Athens, where it heads into residential areas and turns north onto South Main Street.

PA 199 runs past a mix of homes and businesses in Sayre, becoming North Keystone Avenue at the West Lockhart Street intersection.

The road turns north-northeast and becomes Spring Street, running past businesses and crossing the Lehigh Secondary at-grade again.