Kentucky Route 7 begins at a junction with KY 15 at Jeff in Perry County.

Beginning in the early 1960s, KY 7 was relocated near Bruin when a portion of the Little Sandy River was impounded to create Grayson Lake.

The route between Salyersville and Grayson was designated a part of the London-Ashland Highway in the mid-1990s.

[citation needed] As such, much of KY 7 between the southern boundary of Grayson Lake to Sandy Hook has been upgraded or relocated to a new alignment.

The new alignments feature a 60 mph (97 km/h) design speed, full 12-foot (3.7 m) shoulders, and 12-foot (3.7 m) travel lanes.