Nick and Vanessa Lachey returned to host the big event, which was held in Reno Tahoe’s Grand Sierra Resort and Casino’s Grand Theatre.
The group of people judging the queens were Nicole Feld; businesswoman Kim Kaupe (of The Superfan Company); Demi-Leigh Nel-Peters (Miss Universe 2017); marketing executive Ukonwa Ojo; journalist Amy Palmer; Denise Quiñones (Miss Universe 2001); Hillary Schieve, the mayor of Reno; and Patricia Smith (Miss Virginia USA 1994).
Related: Billboard Music Awards: All the Winners
2018 winner, Sarah Rose Summers was also featured on the show to hand her crown to the 2019 winner.
If anything, the telecast wanted to prove just how difficult it was to get the judges on board.
The group of women went through a rigorous amount of questioning and different looks. It wasn't a competition for the faint hearted.
But who went on to win the coveted crown?