It is Corridor G of the Appalachian Development Highway System (ADHS) east of US 23 and KY 80 in Kentucky to Interstate 64 at Charleston, West Virginia.

In Kentucky, US 119 is a two- and four-lane highway running from Pineville at U.S. Route 25E to the West Virginia state line at South Williamson.

It follows the Cumberland River past Harlan to near the source of the river's Poor Fork, crosses Pine Mountain south of Whitesburg, then follows a meandering course along the mountain to Jenkins, where it joins US 23 and turns north to Pikeville.

From Charleston, US 119 heads roughly east along the Elk River to Clendenin, where it turns north for 29 miles (47 km) to Spencer.

Just after the Mileground, US 119 intersects with the Monongalia County Route 857 connector to I-68 Exit #7, which effectively allows through traffic to bypass Morgantown.

Much of this last stretch of US 119 heading towards Uniontown, Pennsylvania is already bypassed by traffic using I-68, CR 857, and PA 857 (or the tolled Mon-Fayette Expressway).

The southern entrance of US 119 is at the West Virginia state line one-half mile south of Point Marion.

US 119's control cities include Morgantown, West Virginia, Uniontown, Connellsville, New Stanton (for northbound traffic only), Greensburg, Blairsville, Indiana, Punxsutawney, and DuBois.

Hwy 119 in Kentucky was originally a series of two-lane roads paralleling Pine Mountain that connected Pineville to Baxter (just north of Harlan) and then headed northeast through Cumberland, Whitesburg, and Pikeville en route to West Virginia.

Small segments of the original route are still in existence as access roads to communities that predate the expansion.

During this stretch in Baxter, Hwy 119 also briefly combines with U.S. Route 421, which then splits off and heads north across Pine Mountain.

On the mountain, Hwy 119 has recently been widened in a number of places in order to make it safer for trucking traffic.

South of Jenkins, Hwy 119 merges with U.S. Route 23 until Pikeville, where it splits off and heads northeast to the West Virginia border.

Past this point, Hwy 119 follows its original route until exiting Kentucky at South Williamson.

At Mountain View, it intersected US 52 and traveled concurrently with it to the northwest, to Williamson, where it entered Kentucky.

This was a four-lane divided highway that contained mountable medians and jersey barriers, with a mix of state route and driveway access.

Two years later,[4] a section of US 119 was relocated on new alignment from 2.5 miles (4.0 km) east of Meta to KY 3154 at Canada.

Segments of this were opened originally as a "super-two" since WV 65 was being destroyed; it was critical that the old roadway be removed before the highway was expanded to four-lanes.

The last segment of Corridor G in West Virginia to be completed was from the Tug Fork crossing at Williamson north to US 52 near Nolan.