It connects Aiken directly with the Savannah River Site and Edgefield via U.S. Route 25 (US 25).

In 1927, US 176 was assigned to SC 19 from Newberry to the North Carolina state line; the following year it was removed from the overlap.

Around 1952, the Savannah River Site was established; which removed nine miles (14 km) of highway in what is now a restricted area.

Just before an intersection with the southern terminus of Thurmond Street, it began a curve to the west-northwest.

It continued on Church Street until it ended at another intersection with SC 19, which existed north of the town at the time.

Sharing a concurrency with SC 121 Conn, it has appeared on official state maps since the 1930s (possibly earlier).