Means made his first career start on April 9th against the Oakland Athletics, pitching three innings while allowing one run. After two more appearances, Means tossed five innings of one-run ball on April 24th against the White Sox, earning his third win of the year and first as a starter. On May 6th, he threw a career-high seven innings, allowing just one run on three hits while striking out four in a 4-1 win over the Red Sox.
On June 28, 2019, Means was selected to his first All-Star Game as a 26-year old rookie, his 2.50 ERA ranking second among American League pitchers for the first half of the season. Starting 27 of 31 pitching appearances, he completed his rookie campaign at 12–11 with a 3.60 ERA. Means was 2nd in the AL in Rookie of Year voting.
This Baltimore Orioles John Means game issued uniform includes MLB holograms on both the jersey and pants, as well as appropriate tagging. The jersey includes the Frank Robinson #20 patch and MLB 100th Anniversary patch.