U.S. Highway 19 (US 19) traverses 145 miles (233 km) across Western North Carolina; from the Georgia state line, at the community of Bellview, to Cane River, where US 19 splits into US 19E and US 19W, which take separate routes into Tennessee.

US 19 enters North Carolina at the Georgia state line overlapped with US 129 and continues toward Cherokee as Lee Highway.

From Ranger to Andrews, the highway is a four-lane expressway that bypasses all the towns and communities along its route.

After Andrews, US 19 reverts to two-lane through the Nantahala Gorge, which both have a scenic and somewhat curvy 21-mile (34 km) route until Almond.

At the start of the Great Smoky Mountains Expressway, US 19 exits off toward the towns of Bryson City and Cherokee.

US 19 joins other highways in Asheville crossing over the French Broad River, then follows I-26 to Mars Hill.

The ADHS provides additional funds, as authorized by Congress, which have enabled US 19 to benefit from the successive improvements along its routing through each corridor.

[5][unreliable source] In the 1940s, additional construction work on US 19 was assured by a compromise made with the Eastern Band of Cherokee Indians in return for right-of-way through the Qualla Boundary for the Blue Ridge Parkway.

In 1984, US 19 was realigned in Yancey County to its current routing and US 19W was extended 0.4 miles (0.64 km) south.

[5] In 1982, the North Carolina Department of Transportation submitted a request to the American Association of State Highway and Transportation Officials to swap US 19 and US 19A between Bryson City and Lake Junaluska; opposition by businesses in the resort town of Maggie Valley, who opposed losing US 19, prevented this.

[6][7] In 1986, US 74 was extended west from Asheville to Chattanooga, Tennessee, which overlapped nearly all of the Great Smoky Mountains Expressway, via US 19 and US 19 Bypass (US 19 Byp.

[19][20] Two bridges over Richland Creek are planned to be replaced in Lake Junaluska, and the interchange with US 23/US 74 is to be redesigned to make it safer.