U.S. Route 219 (US 219) is a part of the U.S. Highway System that runs from Rich Creek, Virginia to West Seneca, New York. In the U.S. state of Maryland, the federal highway runs 48.40 miles (77.89 km) from the West Virginia state line near Red House to the Pennsylvania state line near Grantsville. Known as Garrett Highway for much of its length in Maryland, US 219 is the primary north–south route in Garrett County, connecting Interstate 68 (I-68) and Oakland. The federal highway also provides the main access to the resort area of Deep Creek Lake, which includes Maryland's only ski area, Wisp Ski Resort. US 219 is part of the National Highway System for its entire length in Maryland. The highway is also part of Corridor N of the Appalachian Development Highway System from I-68 to the Pennsylvania state line.

The part of US 219 between Oakland and Keyser's Ridge was designated as part of the original state road system in 1909 by the Maryland State Roads Commission and constructed in the early 1910s. Chestnut Ridge Road near Grantsville was upgraded to a modern road in the late 1910s, while the Seneca Trail south of Oakland was mostly built in the 1920s. The US 219 designation was assigned to Chestnut Ridge Road and Maryland Route 37 (MD 37) was assigned to the highway south of Keyser's Ridge when federal and state route numbers were assigned in 1926 and 1927. The intersection with US 40 near Grantsville was the southern terminus of US 219 until the federal highway was extended through West Virginia in 1935. US 219 was almost completely rebuilt in the 1940s and 1950s, and moved onto I-68 in the late 1970s. Future plans call for a bypass of Oakland and construction of freeway north from I-68 to connect with other freeway portions of US 219 in Pennsylvania.

US 219 enters Maryland in the southwest corner of Garrett County just to the west of Backbone Mountain. The federal highway heads northeast from the West Virginia state line as two-lane Garrett Highway. After crossing the Youghiogheny River, US 219 meets US 50 (George Washington Highway) at an intersection with a two-way stop in the hamlet of Red House. The federal highway turns northwest to intersect Ben Dewitt Road, a shortcut between US 219 north and US 50 west, then resumes its northeast heading toward Gortner, where the highway crosses Cherry Creek and passes Mason School Road. US 219 turns north and crosses the Little Youghiogheny River and CSX's Mountain Subdivision before entering Oakland and meeting the west end of MD 135 (Maryland Highway). The federal highway turns west onto Oak Street, while Ninth Street continues straight along the alignment of the future Oakland Bypass. US 219 continues west into the Oakland Historic District. At the intersection with MD 39 (Oak Street) next to the Garrett County Courthouse, the federal highway turns north onto Third Street. US 219 leaves the town limits of Oakland and regains the name Garrett Highway north of the Walmart Supercenter, where the Oakland Bypass is expected to rejoin the current alignment.

After leaving Oakland, US 219 passes to the east of Mount Nebo and meets the northern end of Sand Flat Road. The federal highway passes Mayhew Inn Road as US 219 enters the hamlet of Thayerville and the Deep Creek Lake resort area. After passing Glendale Road, which heads east toward Deep Creek Lake State Park and other destinations on the east side of the lake, the federal highway turns northwest and parallels the west shore of the lake. After passing Lakeshore Drive, US 219 crosses the lake on the Deep Creek Bridge. The federal highway becomes a partially controlled access highway on the hillside above the lake, while Deep Creek Drive, the old alignment of US 219, follows the shore and provides access to vacation homes. US 219 parallels Marsh Run Cove north into a commercial area in the unincorporated village of McHenry. In McHenry, the federal highway intersects Mosser Road, which provides access to Garrett College and Garrett County Airport, and Sang Run Road, which leads to Wisp Ski Resort. After meeting the northern end of Deep Creek Drive, MD 42 (Friendsville Road) splits to the north and the federal highway re-enters rural areas. US 219 continues northeast, crossing the South Branch of Bear Creek before entering the town of Accident. The federal highway is marked as Main Street and intersects Accident Friendsville Road and Accident Bittinger Road, which heads east toward the James Drane House.

After leaving Accident, US 219 encounters an access road to Bear Creek Road and Fish Hatchery Road near the Kaese Mill before the federal highway crosses the latter road and Bear Creek and begins the ascent to Keyser's Ridge, with the northbound direction gaining a climbing lane. After passing Northern Garrett High School and a scenic overlook, the federal highway curves to the east and then back north as it approaches the summit. The climbing lane ends northbound and another climbing lane begins in the southbound direction. Shortly after the descent from the summit, US 219 meets I-68 (National Freeway) and US 40 at Exit 14 of I-68 in Keyser's Ridge. US 219 exits onto the eastbound direction of the freeway at a cloverleaf interchange, while US 40 heads north from the interchange to meet the west end of US 40 Alternate then turn northwest into Pennsylvania. After meeting MD 495 at Exit 19 in Grantsville, US 219 exits north onto Chestnut Ridge Road at Exit 22. The federal highway intersects US 40 Alternate (National Pike) in the hamlet of High Point before crossing the Pennsylvania state line, where US 219 continues north toward Meyersdale.

In 1909, the Maryland State Roads Commission targeted the pre-existing road from the Northwestern Turnpike at Red House to the National Turnpike at Keyser's Ridge for upgrade to an all-weather road as part of the original state road system. The existing road followed roughly the same alignment as the present US 219, with four major deviations: south of Oakland, where the road followed Monte Vista Road, Underwood Road, and Third Street north to Oak Street; at Deep Creek, where the road crossed Deep Creek to the east of the present Deep Creek Bridge; Hoyes, where the road followed Friendsville Road north to Hoyes, then Hoyes Road east to the present alignment; and north of Accident, where the road turned northeast and used a very curvy alignment to cross Bear Creek and climb the lower slopes of Keyser's Ridge to meet the present road near Northern Garrett High School. The new highway, known as the State Road, was completed from Oakland to Thayerville in 1910. The segment from Thayerville to McHenry, which followed the pre-existing alignment, was under construction by 1911 and completed in 1913. The highway from McHenry to Accident, which bypassed Hoyes, was completed in 1914. Finally, the section from Accident to Keyser's Ridge, which bypassed the crooked road around Bear Creek, was completed in 1915.

Once the highway from Oakland to Keyser's Ridge was completed, attention turned to the south of Oakland. The new road, constructed from Oakland to Gortner in 1915 and 1916, met the road to Mountain Lake Park, now Oakland Drive, next to Southern Garrett High School, then followed Oak Street west into the county seat. The road from Gortner to Red House was constructed between 1924 and 1927. The highway was paved south to the West Virginia state line in 1928. The Chestnut Ridge Road was completed in 1923. The Deep Creek Dam was constructed starting in 1923 and Deep Creek Lake began to fill in January 1925. The State Road was relocated around Deep Creek Lake and the first Deep Creek Bridge was built in 1924. Chestnut Ridge Road was designated the southern end of US 219 in the U.S. Highway System designated in 1926. The road south from Keyser's Ridge was marked as MD 37 in 1927. In 1935, US 219 was extended west along US 40 and then south toward West Virginia, replacing the MD 37 designation for its entire length.

After World War II, US 219 was reconstructed into its modern form for most of its length. The segment between Oakland and Thayerville was reconstructed between 1948 and 1950. The stretch from Keyser's Ridge to Accident was relocated around 1950. The section of US 219 between Gortner and Red House was widened between 1950 and 1952. The stretch between Thayerville and the Deep Creek Bridge was rebuilt from 1952 to 1955. The McHenry to Accident part of US 219 was reconstructed starting in 1952. Chestnut Ridge Road was relocated around 1956. Finally, US 219 between Gortner and Oakland was rebuilt between 1957 and 1959, including a relocation at the northern end that included its present intersection with MD 135 and a bridge over the B&O Railroad. In the late 1960s, US 219 was relocated from the Deep Creek Bridge through McHenry, leaving behind Deep Creek Drive as an old alignment. After the construction of I-68 in the mid-1970s, US 219 was moved to the new freeway between Keyser's Ridge and Chestnut Ridge Road in 1978. The present Deep Creek Bridge was completed in 1987, replacing the 1924 structure.

There are two projects planned for US 219 in Maryland. The Oakland Bypass will run from the present intersection of US 219 and MD 135 on the east edge of the town to US 219 north of the Walmart Supercenter. There are also plans by Maryland and Pennsylvania to upgrade US 219 to a freeway between I-68 east of Grantsville and the existing freeway bypass of Meyersdale.

The entire route is in Garrett County.

US 219 has eight unsigned auxiliary routes, several of which connect with segments of MD 826. US 219A and US 219B are found around Oakland, US 219C through 219G are located between Accident and Keyser's Ridge, and US 219J is near Grantsville.