It heads east for one mile (1.6 km) before turning to the northeast to become parallel to a line of the BNSF Railway.

[2] It travels northeast for 6 miles (9.7 km) and turns east shortly after passing through Essex.

Three miles (4.8 km) east of Essex, Iowa 48 turns north at an intersection with Page County Road J20 (CR J20).

[1] From CR J20, Iowa 48 heads due north for 12+1⁄2 miles (20.1 km) to the intersection with US 34 in Red Oak.

Iowa 48 continues north for 5+1⁄2 miles (8.9 km), again crossing the East Nishnabotna, until its northern end at U.S. Highway 6 west of Lewis.