The first stretch of highway between Perryville and Conowingo in Maryland that would become part of US 222 to be improved was in Perryville, where Cecil County constructed with state aid a macadam road from the Aikin station on the Baltimore and Ohio Railroad south toward the Post Road (now MD 7) by 1910. Cecil County extended the macadam road to the Post Road by 1919. The highway from the Aikin railroad crossing to Port Deposit was paved as a concrete road in two sections: from the railroad to near Port Deposit by 1921 and through Port Deposit by 1923. MD 268, which was the original designation for the road between Perryville and Conowingo, was paved as a concrete road from Port Deposit to US 1 at Conowingo Dam between 1930 and 1933; the construction work included repurposing a railroad bridge across Octoraro Creek as a highway bridge. MD 268's bridge across the Baltimore and Ohio Railroad was constructed between 1931 and 1934. The old highway approaching the Aikin grade crossing became MD 449. MD 268 was proposed to be widened to from US 40 to US 1 in 1934.