New York's 19th congressional district is located in New York's Catskills, Hudson Valley, Southern Tier, and Finger Lakes regions. It lies partially in the northernmost region of the New York metropolitan area and south of Albany. This district is currently represented by Republican Marc Molinaro. It was one of 18 districts that would have voted for Joe Biden in the 2020 presidential election had they existed in their current configuration while being won or held by a Republican in 2022.

The Southern Tier is a geographic subregion of the broader Upstate region of New York State, geographically situated along or very near the state border with Pennsylvania. Definitions of the region vary widely, but generally encompass counties surrounding the Binghamton and Elmira-Corning metropolitan areas. This region is adjacent to the Northern Tier of Pennsylvania, and both these regions together are known as the Twin Tiers.