MD 291 begins in the town of Chestertown at a
roundabout with MD 20 (Chestertown Road) near the eastern terminus of the latter highway, which continues south as High Street toward
downtown Chestertown. MD 291 heads east as two-lane undivided Morgnec Road, which meets the northern terminus of the Gilchrest Rail Trail and passes along the northern edge of
Washington College. The highway intersects
MD 213 (Washington Avenue) at Lees Corner and leaves the town limits shortly before passing the
Maryland State Highway Administration District 2 offices. MD 291 crosses Morgan Creek on a steel
truss bridge on its way to Morgnec, where the highway's name changes to River Road at its intersection with Morgnec Road, which heads north and then east further from the
Chester River than MD 291. The state highway crosses Goosehaven Creek and Norris Creek and meets the eastern end of
MD 298 (Cherry Lane). MD 291 crosses Chesterville Branch between MD 298 and MD 290 (Crumpton Road). MD 291 and MD 290
run concurrently east to a different section of Crumpton Road, on which MD 290 splits north toward Chesterville. MD 291 crosses Mills Branch as it approaches its indirect interchange with US 301 (Blue Star Memorial Highway). The state highway connects with the southbound and northbound directions of the U.S. Highway via Edge Road (
unsigned MD 701A) and Howard Johnson Road (unsigned MD 701), respectively, both of which meet MD 291 at roundabouts. At this interchange, a
park and ride lot is located on the west side of MD 701 north of MD 291. MD 291 continues east into the town of Millington, through which the highway passes as Cypress Street. In the center of town, the highway intersects
MD 313 (Sassafras Street) and the Centreville Branch of the Northern Line of the
Maryland and Delaware Railroad at-grade. MD 291 crosses Cypress Branch to exit Millington along Cypress Road, which the route follows between the Chester River and the
Millington Wildlife Management Area to the Delaware state line. The highway continues as DE 6 (Millington Road) toward the town of
Smyrna. ==History==