It is bordered to the north by the town of Decatur and to the southeast by Interstate 88.

New York State Route 7 is East Worcester's Main Street.

Access to I-88 is either from Exit 19 in Worcester hamlet, 4 miles (6 km) to the southwest along Route 7, or from Exit 20 in Richmondville, 7 miles (11 km) to the east, also via Route 7.

Schenevus Creek rises less than 3 miles (5 km) to the northeast and flows southwest to join the Susquehanna River at Colliersville.

I-88 and State Route 7 follow the creek valley for its entire distance.