 US 19 passes through the limits of the cities and towns of Bluefield, Princeton, Beckley, Oak Hill, Fayetteville, Summersville, Flatwoods, Weston, Jane Lew, Clarksburg, Shinnston, Worthington, Monongah, Fairmont, Rivesville, Westover, Morgantown, Star City, in addition to the smaller communities of Kegley, Spanishburg, Flat Top, Ghent, Cool Ridge, Shady Spring, Daniels, Beaver, Johnstown, Hico, Heaters, Napier, Letch, Ireland, Ben Dale, Homewood, Kitsonville, Hepzibah, Meadowbrook, Enterprise,
Arnettsville, Georgetown.Between Bluefield and Beckley, US 19 has been largely supplanted by Interstate 77 and the West Virginia Turnpike.Between Prosperity and northeast of Canfield, the route serves as a major southwest-northwest artery as Corridor L of the Appalachian Development Highway System (ADHS).