The highway connects mostly rural areas of Johnson and Lawrence counties with Blaine.

KY 201 begins at an intersection with U.S. Route 23 (US 23) north of Paintsville, within Johnson County.

It crosses over the creek, Fitch, Morning, and Sloane branches and intersects the northern terminus of KY 3387 (Head of Hood).

Almost immediately after this intersection, KY 201 enters Lawrence County and Davisville.

It has one final crossing of Dry Fork just before it meets its northern terminus, an intersection with KY 1 in Webbville.