It ran from Mount Airy southeast to Sanford, primarily serving the Piedmont region.
This railroad's short lifespan covered 1899 to 1950, but some of its rails were laid down in the 19th century as part of the Cape Fear and Yadkin Valley Railway (CF&YV) which ran from the Atlantic port of Wilmington, North Carolina, all the way to Mount Airy with a significant branch to Bennettsville, South Carolina.
The questionable legality of the transaction regarding the split of the CF&YV meant years of legal wrangling by angry investors and interested state citizens who saw the only "trunk" line from the western mountains to a North Carolina port split between two competitors.
The renewed profitability combined with the due date for the A&Y's $1.5 million in bonds in the late 1940s led the Southern Railway management to decide to merge the line into its own Winston-Salem Division.
Despite some reservations by the merchants of Greensboro regarding lack of competition for rail transport in that growing city, the Interstate Commerce Commission approved the merger effective January 1, 1950.