Starting at Dyrrachium (now Durrës) on the Adriatic Sea, the road followed a difficult route along the river Genusus (Shkumbin), over the Candaviae (Jablanica) mountains and thence to the highlands around Lake Ohrid.

Like other major Roman roads, it was about six metres (19.6 ft) wide, paved with large polygonal stone slabs or covered with a hard layer of sand.

Bilingual inscriptions on the milestones record that Gnaeus Egnatius, proconsul of Macedonia, ordered its construction,[3] though the exact date is uncertain; the road presumably took its name from its builder.

[4] It may have succeeded an earlier military road from Illyria to Byzantium, as described by Polybius and Cicero, which the Romans apparently built over and/or improved.

It also played a vital role in several key moments in Roman history: the armies of Julius Caesar and Pompey marched along the Via Egnatia during Caesar's civil war, and during the Liberators' civil war Mark Antony and Octavian pursued Cassius and Brutus along the Via Egnatia to their fateful meeting at the Battle of Philippi.

Surviving milestones record that the emperor Trajan undertook extensive repairs of the road prior to his campaign of 113 against the Parthians.