Modern NY 191 is one part of a mostly continuous east–west highway between the hamlets of Altona and Chazy Landing. On September 23, 1908, the state assumed maintenance of the part east of the hamlet of Chazy following the completion of a $38,925 project (equivalent to $ in ) to improve a total of of roads in Clinton County. The section west of the hamlet of Sciota cost $75,711 (equivalent to $ in ) to rebuild to state highway standards, and it became a state highway on December 12, 1918. From Sciota to Chazy, the road was locally maintained until the late 1920s.
