It continues southeast to Storm Lake, where it intersects Iowa Highway 110.

After passing through Storm Lake, it intersects U.S. Highway 71 and goes south with U.S. 71 for 2 miles (3.2 km).

After passing through Manson, it continues east and ends at U.S. Highway 169 in northwestern Fort Dodge.

The eastern end was truncated in 1990 when U.S. Highway 20 was moved to a new freeway alignment south of Fort Dodge.

Iowa Highway 7's former terminus was at U.S. 20, at what is now the corner of Kenyon Road and South 8th Street.