Travelling north, the highway links the prefectural capitals Akita and Aomori.

When bypasses signed as National Route 7 are included, its total distance increases to 559.6 kilometers (347.7 mi).

[2] The highway's origin and southern terminus lies in Chuo-ku, Niigata at junction with national routes 8, 17, 113, 116, 289, 350, and 402.

The highway passes through Shibata, Murakami, Tsuruoka, Sakata, Yurihonjō, Akita, Noshiro, Ōdate, and Hirosaki.

Its endpoint and northern terminus lies in Aomori at a junction with national routes 4 and 45.