The route was created in 1997 when U.S. Highway 63 (US 63) was rerouted along a new, four-lane expressway that subsumed part of a previous Iowa 23.

West of Fremont, the highway follows an east-to-west path until it reaches Cedar, an unincorporated community.

It then enters the city limits of Oskaloosa again where it ends shortly thereafter at Iowa 92.

The first lasted from 1920 to 1926 and went from the South Dakota border west of Sioux City to Fort Dodge.

The third version of Iowa Highway 23 lasted from January 1, 1969, until July 16, 1997, and went from Eddyville to Ottumwa.