SH 59 begins in the south at a junction with U.S. Highway 40 in Kit Carson.

From there, the road proceeds northward for 41 miles (66 km) before intersecting Interstate 70 at that highway's exit 405 just south of the Seibert city limits.

Continuing northward, the road then travels for another 37 miles (60 km) to Haxtun where the route intersects U.S. Highway 6.

After three more miles the road reaches its northern terminus at a junction with U.S. Highway 138 at Sedgwick near the Nebraska state line.

Through nearly its entire length, the road passes through remote, very sparsely populated agricultural areas.