It connects Tamil Nadu's state capital Chennai with Kanyakumari via Puducherry, Cuddalore, Chidambaram, Sirkali, Thirukkadaiyur, Tharangambadi, Karaikal, Nagore, Nagapattinam, Thiruthuraipoondi, Muthupet, Adirampattinam, Manora, Manamelkudi, Mimisal, Ramanathapuram, Rameswaram, Thoothukudi, Tiruchendur, Uvari, Kudankulam.

The Chennai neighbourhoods on ECR are Thiruvanmiyur, Kottivakkam, Palavakkam, Neelankarai, Injambakkam, Panaiyur, Uthandi, Muttukadu, Covelong and Vilambur.

In 2000, the State government signed a concessionaire agreement with the TNRDC in order to improve the road, at a cost of ₹ 60 crore.

The State Government widened most of East Coast Road to a four lane divided, open access highway by 2015.

It is believed that Sri Bhoomiswara is the God for Bhoomi, hence, many perform pooja before buying land placing the sale agreement on his holy feet.