The AA is mostly a two-lane rural highway that provides the only direct connection between Ashland and Northern Kentucky, which includes Cincinnati.

As such, it provides a link between Cincinnati and other Midwestern cities such as Chicago, Indianapolis, and Dayton and cities south and east of Ashland such as Huntington and Charleston in West Virginia, Charlottesville and Richmond in Virginia, and Charlotte and Winston-Salem in North Carolina.

[citation needed] The only municipalities on the highway are Vanceburg and Maysville and suburban areas of Cincinnati at its western terminus.

The only traffic signals on the AA Highway are near Maysville (along a commercial strip with many retail establishments and restaurants), suburban Cincinnati, and at its eastern terminus just north of Interstate 64 near Grayson.

Other than the portions that traverse the edge of Maysville and enter suburban Cincinnati, there are no shopping centers or major retail stores along the AA Highway.

Note that the KY 9 route begins about five miles (8.0 km) north in Newport before it is designated as the AA.

The concurrency ends within Maysville, and upon passing out of the city, the road becomes a two-lane rural highway through an agricultural region.

The KY 10 route continues without the AA designation for about 1.2 miles (1.9 km) before terminating at the Ohio border on the Jesse Stuart Memorial Bridge.

The first phase included the construction of 86 miles (138 km) of the AA Highway from the junction of I-275 and Licking Pike (existing KY 9) in Campbell County east to Vanceburg.

Segments of the highway, from Clarksburg just west of Vanceburg to Tollesboro was routed on an earlier relocated alignment of KY 10.