[16] The entirety of Ronald Reagan Highway has two lanes in each direction, with speed limits ranging from 50 to 60 miles per hour (80 to 95 km/h).

[5][10][20][21] The project, originally estimated at $30 million,[6] was intended to connect the east and west sides of town and relieve congestion on Galbraith Road (State Route 126).

Then, in 1968, it was extended 0.7 miles (1.1 km) further east to Montgomery Road, through the back nine holes of the Swaim Fields golf course, for $1.8 million.

[25] However, this easternmost segment was abandoned after Indian Hill refused to pass a resolution of consent, in an effort to preserve the wealthy village's undeveloped greenbelt.

[27] In 1984, Montgomery city officials unsuccessfully asked the county to either extend the highway east through Indian Hill or truncate it at Interstate 71.

[23] Ohio Department of Transportation (ODOT) straight-line diagrams continue to indicate the unbuilt Montgomery bypass as "future construction".

[1] Two hundred homes were razed in Mount Healthy and North College Hill to make way for construction that would not begin until the mid-1990s.

[6][29] In the meantime, the disconnected western segment saw virtually no traffic, encouraging a significant amount of graffiti on bridges and sound barriers.

The project entailed rechanneling part of Mill Creek and building 18 bridges as well as several retaining walls and sound barriers.

[6] The right-of-way extended through the north end of the Hamilton County Fairgrounds, forcing the race track's relocation.

As part of the rerouting, ODOT District 8 intended to replace the highway's name with the state route shield on all signage, a standard practice due to space constraints.

[37] However, Republican ODOT director Jerry Wray overruled the district office, keeping the President's name alongside the shield.

[47] The highway's oldest 3.7 miles (6.0 km) were upgraded to modern freeway standards from spring 2000 to summer 2001 for $17.6 million.

[48] West Side communities have seen significantly increased commercial development since the highway's completion, attributed in part to decreased congestion on surface streets.

[12] In July 2020, the trumpet interchange and stub ramp at Montgomery Road were demolished, to be replaced with a two-lane turbo roundabout by June 2021 as part of an $8 million reconstruction project.

[51] Before traffic signals were installed in 2018, the intersection between eastbound Ronald Reagan Highway and the entrance ramp from southbound I-71 was the most crash-prone one-tenth-mile-long (0.16 km) stretch of roadway in the Greater Cincinnati area, with 666.39 collisions and 102.53 injuries and fatalities on average annually,[52][53][54] The intersection between the westbound exit ramp of Ronald Reagan Highway and Colerain Avenue had 20 collisions in 2014 (none of which involved injuries), making it the fifth most crash-prone intersection on a Hamilton County road that year.