MD 365 begins at an intersection with US 113 Business (Market Street) just east of downtown Snow Hill.

The state highway heads east as two-lane undivided Bay Street.

After passing the Worcester County Recreation Center, the state highway intersects US 113 (Worcester Highway) at a superstreet intersection, in which MD 365 traffic must turn right, use U-turn ramps along US 113, and turn right again to continue on MD 365.

MD 365 passes through the hamlets of Mount Wesley and Spence before entering Public Landing.

The state highway reaches its eastern terminus at Public Landing Wharf Road adjacent to the shore of Chincoteague Bay.