U.S. Route 19 (US 19) is a part of the United States Numbered Highway System that runs from Memphis, Florida, to Erie, Pennsylvania.

Highways and SR 381 head north along Commonwealth Avenue, a four-lane divided highway that intersects Goode Street one block north of the state line; Goode Street carries US 421 and both US 11 Truck and US 19 Truck through the Bristol Commercial Historic District.

Highways reach the northern end of SR 113 (Moore Street), which heads south toward Virginia Intermont College and downtown Bristol.

US 19 and US 11 pass under Norfolk Southern Railway's Pulaski District and cross Beaver Creek before leaving the city of Bristol.

The two highways continue northeast through Washington County, where they pass Virginia Highlands Airport before entering the town of Abingdon.

enter Russell County at Little Moccasin Gap a short distance east of where the highways diverge at Hansonville.

[1][2] US 19 continues northeast as the Trail of the Lonesome Pine, which has an intersection with SR 80 (Hayters Gap Road) at the hamlet of Smithfield.

At Southwest Virginia Community College at the Russell–Tazewell county line, US 19 veers north through Wardell and crosses the Little River.

The freeway crosses the railroad and the Clinch River at its partial cloverleaf interchange with SR 61 (Riverside Drive).

US 19 heads northeast from its trumpet interchange with US 460 and crosses the rail line into the town of Bluefield, where the highway reduces to a two-lane undivided road and follows Virginia Avenue.

US 19 has a pair of right-angle turns at its crossing of Beaverpond Creek just west of its intersection with SR 102 (College Avenue).