The Monroe County, New York, Department of Transportation maintains 663 miles (1,067 km) of roads as county routes. Unlike most counties in New York, Monroe County does not post reassurance markers along its county routes. In fact, the only field reference to a route's designation are reference markers posted at bridges and culverts along the highway, which carry the county route number on the second line. Routes that do not cross either type of structure at some point are completely unsigned. As a result, county routes in Monroe County are widely known by their road name and not by their number.
Route numbers were initially assigned across the county from east to west, beginning at the Wayne County line and generally progressing westward to the Orleans County line. Subsequent routes (those above County Route 238 or CR 238) do not follow this pattern and are located in all areas of the county. As a general rule, east–west routes have designations ending in an odd number while north–south highways carry designations ending in an even number. Several county routes partially or wholly overlap with New York state touring routes, serving as internal designations for county-maintained segments of those routes.
Several county routes were created, modified, or eliminated following a November 26, 2007, highway maintenance swap between Monroe County and the state of New York. The transaction gave ownership of several county highways to the state, specifically county-maintained sections of New York State Route 19 (NY 19), NY 31, NY 252, NY 259, NY 260, and NY 441, and the county-owned Colonel Patrick O'Rorke Memorial Bridge. In return, the county assumed maintenance of five reference routes (NY 940G, NY 941L, NY 941P, NY 942B, and NY 943B), two sections of NY 386, and all of NY 252A and NY 360.